Provider Demographics
NPI:1841627130
Name:MCNULTY, JENNIFER KEIMIG (MA, ATR-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KEIMIG
Last Name:MCNULTY
Suffix:
Gender:F
Credentials:MA, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10355 BARCAN CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2505
Mailing Address - Country:US
Mailing Address - Phone:410-997-0471
Mailing Address - Fax:
Practice Address - Street 1:1299 NEAL ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3800
Practice Address - Country:US
Practice Address - Phone:202-939-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist