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NPI Code Detail

MEDICARE: JENNIFER HENNESSEE COTA/L

MEDICARE: JENNIFER HENNESSEE COTA/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
1224Z00000XOccupational Therapy Assistant13325FL

General Provider Information

NPI Number : 1205606886
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HENNESSEE COTA/L
Provider Business Mailing Address
First Line : 330 SPRING LAKE HILLS DR
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-3427
Country : US
Telephone Number : 407-761-1905
Fax Number :
Provider Business Practice Location Address
First Line : 1061 S SUN DR STE 1089
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-6169
Country : US
Telephone Number : 407-761-1905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2024
Last Update Date : 01/04/2024

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Directions to “ JENNIFER HENNESSEE COTA/L” Practice Location

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