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NPI Code Detail

MEDICARE: JENNIFER BRANDT OTR

MEDICARE: JENNIFER BRANDT OTR
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
1225X00000XOccupational TherapistOC14826PA

General Provider Information

NPI Number : 1366922361
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BRANDT OTR
Provider Business Mailing Address
First Line : 1440 MOUNT WILSON RD
Second Line :
City : LEBANON
State : PA
Zip : 17042-3828
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 E OREGON RD
Second Line :
City : LITITZ
State : PA
Zip : 17543-9205
Country : US
Telephone Number : 717-381-3540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2018
Last Update Date : 08/19/2018

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