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NPI Code Detail

MEDICARE: JENNIFER JUNE PEREZ OT

MEDICARE: JENNIFER JUNE PEREZ OT
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 Therapist004234MO
2225X00000XOccupational TherapistOTR693AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376678912
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER JUNE PEREZ OT
Provider Business Mailing Address
First Line : 344 FAYETTEVILLE AVE
Second Line :
City : ALMA
State : AR
Zip : 72921-3655
Country : US
Telephone Number : 479-632-4600
Fax Number :
Provider Business Practice Location Address
First Line : 344 FAYETTEVILLE AVE
Second Line :
City : ALMA
State : AR
Zip : 72921-3655
Country : US
Telephone Number : 479-632-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 11/08/2021

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