Provider Demographics
NPI:1851446108
Name:COHEN, JILL S (OTR)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:S
Last Name:COHEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 LAS COLINAS WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7716
Mailing Address - Country:US
Mailing Address - Phone:954-648-1118
Mailing Address - Fax:
Practice Address - Street 1:10371 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3941
Practice Address - Country:US
Practice Address - Phone:954-341-0090
Practice Address - Fax:954-341-2252
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9980225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist