Provider Demographics
NPI:1679030506
Name:KAPLAN, JEANINE A R (OT)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:A R
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:JEANINE
Other - Middle Name:A
Other - Last Name:ROSSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:1115 BOULDERS PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:804-968-1803
Practice Address - Street 1:13801 ST FRANCIS BLVD # 200
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3206
Practice Address - Country:US
Practice Address - Phone:804-320-4604
Practice Address - Fax:804-287-2786
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008038225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist