Provider Demographics
NPI:1760568125
Name:MCCLANAHAN, JENNIFER CUMMINGS (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CUMMINGS
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:CUMMINGS
Other - Last Name:LUALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:370 OLD SHACKLE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:615-824-0720
Mailing Address - Fax:615-824-0272
Practice Address - Street 1:370 OLD SHACKLE ISLAND RD.
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-824-0720
Practice Address - Fax:615-824-0272
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2231225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist