Provider Demographics
NPI:1821816166
Name:CHARTIER, JENNIFER RAE (COTA/L)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RAE
Last Name:CHARTIER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHINA GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28023-2037
Mailing Address - Country:US
Mailing Address - Phone:610-816-1874
Mailing Address - Fax:
Practice Address - Street 1:707 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3917
Practice Address - Country:US
Practice Address - Phone:336-885-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17097224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant