Provider Demographics
NPI:1366474256
Name:JENNINGS, JODI L (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:L
Last Name:JENNINGS
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 1:1201 W. BOYD ST.
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4801
Mailing Address - Country:US
Mailing Address - Phone:405-366-7898
Mailing Address - Fax:405-366-0010
Practice Address - Street 1:1201 W. BOYD ST.
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4801
Practice Address - Country:US
Practice Address - Phone:405-366-7898
Practice Address - Fax:405-366-0010
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013209/1225XP0200X
OK792225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100644420BMedicaid