Provider Demographics
NPI:1891139838
Name:FELLOWS, JENNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FELLOWS
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 1:147 ATTENBOROUGH DR
Mailing Address - Street 2:APT. 302
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4999
Mailing Address - Country:US
Mailing Address - Phone:301-471-1961
Mailing Address - Fax:
Practice Address - Street 1:8710 EMGE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3504
Practice Address - Country:US
Practice Address - Phone:410-810-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06608225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation