Provider Demographics
NPI:1740334390
Name:OHLSEN, JESSY LYN (OTRL)
Entity type:Individual
Prefix:
First Name:JESSY
Middle Name:LYN
Last Name:OHLSEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:JESSY
Other - Middle Name:LYN
Other - Last Name:FIALKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:101 MONROE LN
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6956
Mailing Address - Country:US
Mailing Address - Phone:877-407-3422
Mailing Address - Fax:877-407-4329
Practice Address - Street 1:801 KINGS HWY N
Practice Address - Street 2:FOX REHABILITATION SERVICES
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1513
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00077000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist