Provider Demographics
NPI:1669088118
Name:WINSLOW, JENNA MARGARET (LMT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARGARET
Last Name:WINSLOW
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 1:1121 9TH ST APT F
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2339
Mailing Address - Country:US
Mailing Address - Phone:781-964-1482
Mailing Address - Fax:
Practice Address - Street 1:1121 9TH ST APT F
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-2339
Practice Address - Country:US
Practice Address - Phone:781-964-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA9209225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist