Provider Demographics
NPI:1629774104
Name:FEENEY, JENNA N (OT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:N
Last Name:FEENEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:NICHOLE
Other - Last Name:FEENEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:950 E COUNTY LINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-1928
Mailing Address - Country:US
Mailing Address - Phone:601-487-6088
Mailing Address - Fax:601-487-6068
Practice Address - Street 1:950 E COUNTY LINE RD STE A
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1928
Practice Address - Country:US
Practice Address - Phone:601-487-6088
Practice Address - Fax:601-487-6068
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT-4012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist