Provider Demographics
NPI:1346710563
Name:RABER, JENNA (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:
Last Name:RABER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 DAVENPORT DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4231
Mailing Address - Country:US
Mailing Address - Phone:727-277-6812
Mailing Address - Fax:727-375-1743
Practice Address - Street 1:1649 DAVENPORT DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-4231
Practice Address - Country:US
Practice Address - Phone:727-277-6812
Practice Address - Fax:727-375-1743
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19633225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist