Provider Demographics
NPI:1740807635
Name:SEMRAU, JENNA JEAN (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:JEAN
Last Name:SEMRAU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:JEAN
Other - Last Name:SCHYMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10635 RAVEN LOOP
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56329-9008
Mailing Address - Country:US
Mailing Address - Phone:320-291-3451
Mailing Address - Fax:
Practice Address - Street 1:2653 COUNTY ROAD 74
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-2205
Practice Address - Country:US
Practice Address - Phone:320-291-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106261225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics