Provider Demographics
NPI:1720720626
Name:JUMP, EMILY KARA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KARA
Last Name:JUMP
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:KARA
Other - Last Name:JUMP-REITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:5227 CRYSTAL DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5227 CRYSTAL DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3828
Practice Address - Country:US
Practice Address - Phone:513-364-7567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA006603224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant