Provider Demographics
NPI:1033616404
Name:WESTMAN-MINNIG, JENNY ELIZABETH
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:ELIZABETH
Last Name:WESTMAN-MINNIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4406
Mailing Address - Country:US
Mailing Address - Phone:410-444-5000
Mailing Address - Fax:
Practice Address - Street 1:3501 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-4406
Practice Address - Country:US
Practice Address - Phone:410-444-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7774225CX0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training ProviderGroup - Single Specialty