MEDICARE: JENNA MYER

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

General Provider Information

NPI Number	:	1770217663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA MYER

Provider Business Mailing Address
First Line	:	900 N 24TH ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-6412
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6740 FOREST HILL AVE STE 101
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1847
Country	:	US
Telephone Number	:	804-562-7307
Fax Number	:

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

Provider Enumeration Date	:	07/15/2022
Last Update Date	:	05/09/2025

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