MEDICARE: MRS. JENNIFER JEWEL PALMER 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
1	225X00000X	Occupational Therapist	109072	TX

General Provider Information

NPI Number	:	1508112434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER JEWEL PALMER OTR

Provider Business Mailing Address
First Line	:	543 RAMBLEWOOD RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-6902
Country	:	US
Telephone Number	:	713-560-8007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 ENCLAVE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3671
Country	:	US
Telephone Number	:	281-617-1141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2012
Last Update Date	:	07/29/2012

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