Provider Demographics
NPI:1144769431
Name:RENSHAW, JENNIFER K (OTD,OTRL)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:K
Last Name:RENSHAW
Suffix:
Gender:F
Credentials:OTD,OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5919 OLEANDER DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4780
Mailing Address - Country:US
Mailing Address - Phone:910-395-2995
Mailing Address - Fax:910-313-0951
Practice Address - Street 1:5919 OLEANDER DR
Practice Address - Street 2:SUITE 119
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4780
Practice Address - Country:US
Practice Address - Phone:910-395-2995
Practice Address - Fax:910-313-0951
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8034225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics