Provider Demographics
NPI:1891266649
Name:SCHWARTZ, JEANETTE LYNN (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:LYNN
Last Name:SCHWARTZ
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 1:1611 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-7577
Mailing Address - Country:US
Mailing Address - Phone:785-317-1111
Mailing Address - Fax:
Practice Address - Street 1:1408 POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4145
Practice Address - Country:US
Practice Address - Phone:785-776-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist