Provider Demographics
NPI:1083920649
Name:HOVEN, JENNIFER BRONWEN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BRONWEN
Last Name:HOVEN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 NEWCASTLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-1243
Mailing Address - Country:US
Mailing Address - Phone:309-444-1065
Mailing Address - Fax:309-444-1095
Practice Address - Street 1:1201 NEWCASTLE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-1243
Practice Address - Country:US
Practice Address - Phone:309-444-1065
Practice Address - Fax:309-444-1095
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057002463174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist