Provider Demographics
NPI:1508901737
Name:HALE, JENNIFER L (OT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:HALE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:832 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE NUMBER 300A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4633
Mailing Address - Country:US
Mailing Address - Phone:972-424-4243
Mailing Address - Fax:972-424-6211
Practice Address - Street 1:832 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE NUMBER 300A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4633
Practice Address - Country:US
Practice Address - Phone:972-424-4243
Practice Address - Fax:972-424-6211
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111083OtherSTATE LICENSE
TX8T6135OtherBLUE CROSS BLUE SHIELD