Provider Demographics
NPI:1649533936
Name:VOTH-EDRI, JENNIFER C
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:C
Last Name:VOTH-EDRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16356 E PIMLICO DR
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4025
Mailing Address - Country:US
Mailing Address - Phone:561-714-4026
Mailing Address - Fax:
Practice Address - Street 1:2708 NE 14TH STREET, SUITE 5
Practice Address - Street 2:BUTTERFLY EFFECTS
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-3564
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist