Provider Demographics
NPI:1659153237
Name:WHITMAN, JENNA (OTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4731 CENTENNIAL BLVD APT 355
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1982
Mailing Address - Country:US
Mailing Address - Phone:215-692-9128
Mailing Address - Fax:
Practice Address - Street 1:3443 DICKERSON PIKE STE G20
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2597
Practice Address - Country:US
Practice Address - Phone:615-769-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7445225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist