Provider Demographics
NPI:1013155951
Name:THOMAS, JENNIFER (OTR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:THOMAS
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 1:398 FINCASTLE ROAD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697
Mailing Address - Country:US
Mailing Address - Phone:937-695-0839
Mailing Address - Fax:
Practice Address - Street 1:398 FINCASTLE RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45697-9783
Practice Address - Country:US
Practice Address - Phone:937-695-0839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR1825225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist