Provider Demographics
NPI:1003369745
Name:KLESAT, JENNIFER (OT, CHT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KLESAT
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1323
Mailing Address - Country:US
Mailing Address - Phone:908-237-1003
Mailing Address - Fax:
Practice Address - Street 1:8100 WESCOTT DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4671
Practice Address - Country:US
Practice Address - Phone:908-788-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR0003300225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand