Provider Demographics
NPI:1609018829
Name:LURI, JENNIFER LESLIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LESLIE
Last Name:LURI
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 1:747 INDIAN TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-6507
Mailing Address - Country:US
Mailing Address - Phone:775-722-3323
Mailing Address - Fax:
Practice Address - Street 1:747 INDIAN TRAIL RD
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89460-6507
Practice Address - Country:US
Practice Address - Phone:775-722-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0308225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist