Provider Demographics
NPI:1326614280
Name:JOSEPH, JUDITH JENKINS (OTR)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:JENKINS
Last Name:JOSEPH
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 1:9515 GULF BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-5016
Mailing Address - Country:US
Mailing Address - Phone:713-408-1217
Mailing Address - Fax:
Practice Address - Street 1:9515 GULF BRIDGE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-5016
Practice Address - Country:US
Practice Address - Phone:713-408-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107258225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist