Provider Demographics
NPI:1518591288
Name:KNITTEL, JENNIFER M (MT-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:KNITTEL
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 JACKSON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07863-3318
Mailing Address - Country:US
Mailing Address - Phone:908-319-5453
Mailing Address - Fax:
Practice Address - Street 1:134 JACKSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NJ
Practice Address - Zip Code:07863-3318
Practice Address - Country:US
Practice Address - Phone:908-319-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
06101225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty