Provider Demographics
NPI:1639373145
Name:TAYLOR, JENNIFER DIONNE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DIONNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:DIONNE
Other - Last Name:MORTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:1117 WYNBROOK RD
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-7026
Mailing Address - Country:US
Mailing Address - Phone:443-306-4672
Mailing Address - Fax:
Practice Address - Street 1:811 CROMWELL PARK DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2566
Practice Address - Country:US
Practice Address - Phone:410-590-4926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05085225XN1300X, 225XE0001X, 225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation