Provider Demographics
NPI:1790554517
Name:BUENING, JESSICA M (OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:BUENING
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 HAVENCREST CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3841
Mailing Address - Country:US
Mailing Address - Phone:419-575-8423
Mailing Address - Fax:
Practice Address - Street 1:4590 KNIGHTSBRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4327
Practice Address - Country:US
Practice Address - Phone:614-451-6793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist