Provider Demographics
NPI: | 1932644218 |
---|---|
Name: | TREVINO, JENNIFER (OTR/L) |
Entity Type: | Individual |
Prefix: | |
First Name: | JENNIFER |
Middle Name: | |
Last Name: | TREVINO |
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: | 1234 KATAHDIN CT |
Mailing Address - Street 2: | |
Mailing Address - City: | WESLEY CHAPEL |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33543-6860 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-442-1204 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1234 KATAHDIN CT |
Practice Address - Street 2: | |
Practice Address - City: | WESLEY CHAPEL |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33543-6860 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-442-1204 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2016-12-22 |
Last Update Date: | 2021-10-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
225XE0001X, 225XE1200X, 225XG0600X, 225XH1300X, 225XL0004X, 225XM0800X, 225XP0019X | ||
FL | OT 13224 | 225X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification |
No | 225XE1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Ergonomics |
No | 225XG0600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology |
No | 225XH1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Human Factors |
No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision |
No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |