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NPI Code Detail

MEDICARE: JENNIFER HEWITT OTD

MEDICARE: JENNIFER HEWITT OTD
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
1225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1407960255
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HEWITT OTD
Provider Business Mailing Address
First Line : 49352 FEDELE RD
Second Line :
City : TICKFAW
State : LA
Zip : 70466-1840
Country : US
Telephone Number : 985-662-2126
Fax Number :
Provider Business Practice Location Address
First Line : 2106 RUE SIMONE
Second Line :
City : HAMMOND
State : LA
Zip : 70403-5728
Country : US
Telephone Number : 985-662-5448
Fax Number : 985-662-2571
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 01/02/2024

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