Provider Demographics
NPI:1811203565
Name:JENNINGS, LINDA A (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:JENNINGS
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 1:38130 PRETTY POND RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-1419
Mailing Address - Country:US
Mailing Address - Phone:813-783-3653
Mailing Address - Fax:813-783-3674
Practice Address - Street 1:38130 PRETTY POND RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-1419
Practice Address - Country:US
Practice Address - Phone:813-783-3653
Practice Address - Fax:813-783-3674
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 14255225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist