Jennifer L Blair, OTR/L

Individual provider Active NPI Occupational Therapist · Hermann, MO

NPI 1093099384 · NPPES record last updated Oct 5, 2011

Key facts

NPI
1093099384
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2002016412 (MO)
Practice address
170 Blue Pride Drive
Hermann, MO 65041-1593
Phone
(573) 486-2116
Fax
(573) 486-5106
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2002016412MOMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2002016412 MO Yes

Addresses

Primary practice location

170 Blue Pride Drive
Hermann, MO 65041-1593

Mailing address

170 Blue Pride Drive
Hermann, MO 65041-1593
Phone (573) 486-2116

Other providers in Hermann, MO

All providers in Hermann, MO · Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.