Provider Demographics
NPI:1851458285
Name:MASTERS, JENNIFER A (OTR L)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:MASTERS
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 1:50 STEDMAN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1221
Mailing Address - Country:US
Mailing Address - Phone:617-471-2969
Mailing Address - Fax:
Practice Address - Street 1:60 HODGES AVE
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3034
Practice Address - Country:US
Practice Address - Phone:508-977-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6499225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist