Provider Demographics
NPI:1881791952
Name:SEXTON, JENNIFER DAVIS (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAVIS
Last Name:SEXTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 SPLENDOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-6534
Mailing Address - Country:US
Mailing Address - Phone:606-451-9733
Mailing Address - Fax:606-451-9733
Practice Address - Street 1:892 SPLENDOR VIEW DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-6534
Practice Address - Country:US
Practice Address - Phone:606-451-9733
Practice Address - Fax:606-451-9733
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2144225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist