Provider Demographics
NPI:1225229982
Name:LUPINI, JEANETTE M (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:M
Last Name:LUPINI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 CISLO CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-8700
Mailing Address - Country:US
Mailing Address - Phone:843-824-6933
Mailing Address - Fax:
Practice Address - Street 1:2375 BAKER HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8233
Practice Address - Country:US
Practice Address - Phone:843-744-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2454225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist