Provider Demographics
NPI:1831492412
Name:WEBER, JENNIFER DENISE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DENISE
Last Name:WEBER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12105 EDGEMONT ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1032
Mailing Address - Country:US
Mailing Address - Phone:215-206-5657
Mailing Address - Fax:
Practice Address - Street 1:850 HUNGERFORD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1718
Practice Address - Country:US
Practice Address - Phone:240-740-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09291225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist