Provider Demographics
NPI:1932273224
Name:WESSELS, JENNIFER ANN (OT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:WESSELS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 OLD STATE RD
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2834
Mailing Address - Country:US
Mailing Address - Phone:859-581-9125
Mailing Address - Fax:
Practice Address - Street 1:11129 KENWOOD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-1817
Practice Address - Country:US
Practice Address - Phone:513-872-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH052683225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist