Provider Demographics
NPI:1972852515
Name:WHEELER, JENNIFER RUTH (MS, OTR / L)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RUTH
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MS, OTR / L
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RUTH
Other - Last Name:LOUNSBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR / L
Mailing Address - Street 1:1000 ELMWOOD AVE SUITE 100
Mailing Address - Street 2:(MARY CARIOLA CHILDRENS CENTER)
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620
Mailing Address - Country:US
Mailing Address - Phone:315-657-7238
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE SUITE 100
Practice Address - Street 2:(MARY CARIOLA CHILDRENS CENTER)
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-271-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017817225XP0200X
NY017817-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics