Provider Demographics
NPI:1598326241
Name:THOMPSON, JENNIFER KAY (OTR/L)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KAY
Other - Last Name:DOUGHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2171 BRIDGEPORT DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-5193
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2171 BRIDGEPORT DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-5193
Practice Address - Country:US
Practice Address - Phone:513-460-7509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT006707225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist