Provider Demographics
NPI:1972169878
Name:KOSINSKI, JASMINE (OTR)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:KOSINSKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 1ST AVE S
Mailing Address - Street 2:STE 200
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4364
Mailing Address - Country:US
Mailing Address - Phone:219-508-5595
Mailing Address - Fax:
Practice Address - Street 1:60250 CRUMSTOWN HWY
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IN
Practice Address - Zip Code:46554-9753
Practice Address - Country:US
Practice Address - Phone:219-508-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT20305225X00000X
IN31006759A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist