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NPI Code Detail

MEDICARE: MRS. JENNIFER JANSZEN COTA/L

MEDICARE: MRS. JENNIFER JANSZEN 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 AssistantOTA01093OH

General Provider Information

NPI Number : 1306096060
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER JANSZEN COTA/L
Provider Business Mailing Address
First Line : 8637 BRIDGETOWN RD
Second Line :
City : CLEVES
State : OH
Zip : 45002-1325
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5999 BENDER RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45233-1601
Country : US
Telephone Number : 513-922-1440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2008
Last Update Date : 01/04/2013

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