Provider Demographics
NPI:1588856090
Name:HURLEY, JENNIFER T (OTR L)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:T
Last Name:HURLEY
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 1:2806 MATTHEW DR
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-7981
Mailing Address - Country:US
Mailing Address - Phone:660-829-6471
Mailing Address - Fax:660-826-1020
Practice Address - Street 1:2806 MATTHEW DR
Practice Address - Street 2:SEDALIA 200
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-7981
Practice Address - Country:US
Practice Address - Phone:660-829-6471
Practice Address - Fax:660-826-1020
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000799225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist