Provider Demographics
NPI:1457772667
Name:VEHABA, JENNIFER (LMT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:VEHABA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 PEACEABLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-3028
Mailing Address - Country:US
Mailing Address - Phone:845-279-8944
Mailing Address - Fax:
Practice Address - Street 1:174 PEACEABLE HILL RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-3028
Practice Address - Country:US
Practice Address - Phone:845-279-8944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist