Provider Demographics
NPI:1619439148
Name:FULOP, JEMMA ANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEMMA
Middle Name:ANNE
Last Name:FULOP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JEMMA
Other - Middle Name:ANNE
Other - Last Name:FULOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JEMMA HEJNAR
Mailing Address - Street 1:11516 HUNTERS RUN DR
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-1941
Mailing Address - Country:US
Mailing Address - Phone:410-683-8304
Mailing Address - Fax:
Practice Address - Street 1:9834 GREENSIDE DR
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-5006
Practice Address - Country:US
Practice Address - Phone:410-887-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist