Jennifer Leight Bolam, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131000679 Issued in VA

Practice address

915 Glynn Springs Dr
Williamsburg, VA 23188-2832

Phone

(757) 206-6347

NPI assigned

Dec 13, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1295038347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 GLYNN SPRINGS DR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882832",
            "telephone_number": "757-206-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GLYNN SPRINGS DR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882832",
            "telephone_number": "757-206-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAM",
        "first_name": "JENNIFER",
        "middle_name": "LEIGHT",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florinda Blocker
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• Blue Harbor Counseling PLLC
• Kenneth Boecker, D.C.
• Mary Angela Boland, LCP
• Stacy Kline Bolling, LPC
• Janis Bolton, LCSW
• David Thompson Bond, PSY.D
• Harley Bonniville, CPNP-PC

• Occupational Therapy Assistant in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.