MEDICARE: JENNIFER LYNN BRINN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	05172	MD

General Provider Information

NPI Number	:	1184291494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN BRINN OTR/L

Provider Business Mailing Address
First Line	:	1838A SNYDERSBURG RD
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-3423
Country	:	US
Telephone Number	:	410-428-2044
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 ANTRIM BLVD
Second Line	:
City	:	TANEYTOWN
State	:	MD
Zip	:	21787-2288
Country	:	US
Telephone Number	:	410-756-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2021
Last Update Date	:	06/06/2021

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