Provider Demographics
NPI:1376702092
Name:HOWERTON, JENIFER ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:ANN
Last Name:HOWERTON
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 1:420 ROWE ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-9319
Mailing Address - Country:US
Mailing Address - Phone:208-882-4576
Mailing Address - Fax:
Practice Address - Street 1:420 ROWE ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-9319
Practice Address - Country:US
Practice Address - Phone:208-882-4576
Practice Address - Fax:208-892-8776
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-601225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist