Provider Demographics
NPI:1588010078
Name:OPPENHUIZEN, JESSICA (MOT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:OPPENHUIZEN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 TIMBER CREEK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4285
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 TIMBER CREEK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4285
Practice Address - Country:US
Practice Address - Phone:901-309-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics