Provider Demographics
NPI:1043652852
Name:MAERZ-BLETSCH, JESSICA BARBARA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BARBARA
Last Name:MAERZ-BLETSCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:MAERZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:30-81 54TH STREET
Mailing Address - Street 2:APT 4A
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-1467
Mailing Address - Country:US
Mailing Address - Phone:516-351-5330
Mailing Address - Fax:212-238-7009
Practice Address - Street 1:30-81 54TH STREET
Practice Address - Street 2:APT 4A
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-1467
Practice Address - Country:US
Practice Address - Phone:516-351-5330
Practice Address - Fax:212-238-7009
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018135225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist