Provider Demographics
NPI:1962838755
Name:SENECAL, JILLIAN E (OTR/L)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:E
Last Name:SENECAL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:E
Other - Last Name:KEEFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:41 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2505
Mailing Address - Country:US
Mailing Address - Phone:413-244-0112
Mailing Address - Fax:
Practice Address - Street 1:303 N HURSTBOURNE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5158
Practice Address - Country:US
Practice Address - Phone:502-412-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10891225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist