Jenna R Cannon, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Elsberry, MO

NPI 1194598904 · NPPES record last updated Aug 1, 2025

Key facts

NPI
1194598904
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
138 Tomahawk Dr
Elsberry, MO 63343-1151
Phone
(573) 898-5554
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln County R2 School District Past
since Nov 5, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X Yes

Addresses

Primary practice location

138 Tomahawk Dr
Elsberry, MO 63343-1151

Mailing address

56 Straight St
Elsberry, MO 63343-3503
Phone (636) 578-7352

Other providers in Elsberry, MO

All providers in Elsberry, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.