Provider Demographics
NPI:1891930236
Name:BACHELOR, JENNIFER LEE (OT/L, DRP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEE
Last Name:BACHELOR
Suffix:
Gender:F
Credentials:OT/L, DRP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LEE
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:670 MERIDIAN WAY
Mailing Address - Street 2:SUITE 262
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7648
Mailing Address - Country:US
Mailing Address - Phone:740-777-6896
Mailing Address - Fax:855-402-3455
Practice Address - Street 1:670 MERIDIAN WAY
Practice Address - Street 2:SUITE 262
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7648
Practice Address - Country:US
Practice Address - Phone:740-777-6896
Practice Address - Fax:855-402-3455
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 004026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2155984Medicaid