Provider Demographics
NPI:1154836021
Name:VALENT, JENNIFER A (COTA/L)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:VALENT
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 1:1739 COLONY DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1101
Mailing Address - Country:US
Mailing Address - Phone:484-769-3768
Mailing Address - Fax:
Practice Address - Street 1:1040 BERK RD
Practice Address - Street 2:
Practice Address - City:LEESPORT
Practice Address - State:PA
Practice Address - Zip Code:19533-8700
Practice Address - Country:US
Practice Address - Phone:610-376-4841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP008725224ZR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility