Provider Demographics
NPI:1346538477
Name:COURTNEY, JEANMARIE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:JEANMARIE
Middle Name:
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:JEANMARIE
Other - Middle Name:NIEDERMEYER
Other - Last Name:COURTNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:41 O' CONNOR ROAD
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450
Mailing Address - Country:US
Mailing Address - Phone:585-383-6648
Mailing Address - Fax:
Practice Address - Street 1:41 O'CONNOR ROAD
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450
Practice Address - Country:US
Practice Address - Phone:585-313-1995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006738225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist