Provider Demographics
NPI:1073661153
Name:SEMLE, JENNIFER RATH (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RATH
Last Name:SEMLE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MYSTIC VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-2162
Mailing Address - Country:US
Mailing Address - Phone:609-334-3910
Mailing Address - Fax:609-324-3826
Practice Address - Street 1:6 MYSTIC VALLEY LN
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-2162
Practice Address - Country:US
Practice Address - Phone:609-334-3910
Practice Address - Fax:609-324-3826
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000683002255A2300X
MA19912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer