MEDICARE: CHERINA LANAE' JONES O.T.R

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	110605	TX

General Provider Information

NPI Number	:	1518269406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERINA LANAE' JONES O.T.R

Provider Business Mailing Address
First Line	:	2800 JEANETTA ST
Second Line	:	#301
City	:	HOUSTON
State	:	TX
Zip	:	77063-4049
Country	:	US
Telephone Number	:	832-492-6700
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	:	281-920-0573
Fax Number	:

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

Provider Enumeration Date	:	11/26/2010
Last Update Date	:	11/26/2010

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