Provider Demographics
NPI:1376289751
Name:HOOD, JENNIE (OTR/L, CSRS)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:HOOD
Suffix:
Gender:F
Credentials:OTR/L, CSRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3961 E GUADALUPE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3266
Mailing Address - Country:US
Mailing Address - Phone:480-699-4845
Mailing Address - Fax:
Practice Address - Street 1:3961 E GUADALUPE RD STE 1
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-3266
Practice Address - Country:US
Practice Address - Phone:480-699-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4698225X00000X
AZOTH-008529225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist