Provider Demographics
NPI:1619035680
Name:HOWARD, JENNIFER SEBERT (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SEBERT
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ELAINE
Other - Last Name:SEBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:PO BOX 32071
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28608-6111
Mailing Address - Country:US
Mailing Address - Phone:828-262-7985
Mailing Address - Fax:
Practice Address - Street 1:1179 STATE FARM RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4943
Practice Address - Country:US
Practice Address - Phone:828-262-7985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer