Provider Demographics
NPI:1467561134
Name:BELLEN, JENNIFER LYNN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BELLEN
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 1:8 WALDEN DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3024
Mailing Address - Country:US
Mailing Address - Phone:603-226-3212
Mailing Address - Fax:603-226-3354
Practice Address - Street 1:525 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4609
Practice Address - Country:US
Practice Address - Phone:603-226-3212
Practice Address - Fax:603-226-3354
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH21344YMedicare UPIN