Provider Demographics
NPI:1952371544
Name:DOVE, JACQUELINE R (OT, CHT)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:R
Last Name:DOVE
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:R
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13020 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0925
Mailing Address - Country:US
Mailing Address - Phone:813-978-9700
Mailing Address - Fax:813-558-6494
Practice Address - Street 1:2414 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1751
Practice Address - Country:US
Practice Address - Phone:727-461-6026
Practice Address - Fax:727-796-4345
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02755225X00000X, 225XH1200X
FLOT22505225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand