Provider Demographics
NPI:1114951530
Name:RIGHTHOUSE, JENNIFER B (OT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:RIGHTHOUSE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 BARDSTOWN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2665
Mailing Address - Country:US
Mailing Address - Phone:502-452-1863
Mailing Address - Fax:502-452-1863
Practice Address - Street 1:2525 BARDSTOWN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2665
Practice Address - Country:US
Practice Address - Phone:502-452-1863
Practice Address - Fax:502-452-1863
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R1579225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9517Medicare ID - Type Unspecified