MEDICARE: JACLYNNE DANIELLE VAN OOTEGHEM

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	120563	TX

General Provider Information

NPI Number	:	1770441552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYNNE DANIELLE VAN OOTEGHEM

Provider Business Mailing Address
First Line	:	3223 LEMMON AVE APT 2126
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-1817
Country	:	US
Telephone Number	:	972-251-0487
Fax Number	:

Provider Business Practice Location Address
First Line	:	3223 LEMMON AVE APT 2126
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-1817
Country	:	US
Telephone Number	:	972-251-0487
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

Similar Medicare Providers

1306897590 — SHEPHARD HOME HEALTH INC.
Practice Location Address:

655 W ILLINOIS AVE , SUITE 911
DALLAS, TX
75224-1817

Practice Phone: 972-904-4292
Practice Fax:

1609827765 — DR. IREDIA JOE EKUKPE O.D.
Practice Location Address:

655 W ILLINOIS AVE , #911
DALLAS, TX
75224-1817

Practice Phone: 214-941-9600
Practice Fax: 214-941-9623

1588817274 — INGLES MARKETS INC
Practice Location Address:

1817 DALLAS- NEBO RD
DOUGLASVILLE, GA
30134

Practice Phone: 678-383-8717
Practice Fax: 678-383-8716

1811433857 — SOPHAKHONTERRY SON
Practice Location Address:

1817 DALLAS NEBO RD
DOUGLASVILLE, GA
30134-4865

Practice Phone: 678-383-8715
Practice Fax: 678-383-8716

1326585068 — DR. PAUL KIARIE MUCHENE I PHARM.D
Practice Location Address:

1817 DALLAS NEBO RD
DOUGLASVILLE, GA
30134-4865

Practice Phone: 678-383-8715
Practice Fax:

1396678397 — CRANIAL CONFIDENCE SOLUTIONS LLC
Practice Location Address:

2626 COLE AVE STE 300
DALLAS, TX
75204-1094

Practice Phone: 972-954-4233
Practice Fax: 214-845-5530

Directions to “ JACLYNNE DANIELLE VAN OOTEGHEM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.