Provider Demographics
NPI:1295979367
Name:CATO, JENNIFER REBECCA
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:REBECCA
Last Name:CATO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:REBECCA
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4421 TREEHOUSE LN
Mailing Address - Street 2:21E
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3348
Mailing Address - Country:US
Mailing Address - Phone:954-298-3743
Mailing Address - Fax:
Practice Address - Street 1:4421 TREEHOUSE LN
Practice Address - Street 2:21E
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-3348
Practice Address - Country:US
Practice Address - Phone:954-298-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL860796222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist