Provider Demographics
NPI:1225456619
Name:RAPP, JESSICA MARY (OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARY
Last Name:RAPP
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 1:131 E 104TH ST
Mailing Address - Street 2:PS 72, THE LEXINGTON ACADEMY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 E 104TH ST
Practice Address - Street 2:PS 72, THE LEXINGTON ACADEMY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4921
Practice Address - Country:US
Practice Address - Phone:212-860-5831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018656225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist