Provider Demographics
NPI:1235337262
Name:JARZOMBEK, JENNIFER A (OTR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:JARZOMBEK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45650 SCHOENHERR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-6033
Mailing Address - Country:US
Mailing Address - Phone:586-532-0803
Mailing Address - Fax:586-532-0883
Practice Address - Street 1:45650 SCHOENHERR RD
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-6033
Practice Address - Country:US
Practice Address - Phone:586-532-0803
Practice Address - Fax:586-532-0883
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004343225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist