Jenna M Douglas, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Kenton, OH
NPI 1487299442 · NPPES record last updated Nov 14, 2019
Key facts
- NPI
- 1487299442
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA.006013 (OH)
- Practice address
- 553 E Pattison Ave
Kenton, OH 43326-1440 - Phone
- (419) 302-1306
- NPI assigned
- Nov 14, 2019
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA.006013 | OH | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA.006013 | OH | Yes |
Addresses
Primary practice location
553 E Pattison Ave
Kenton, OH 43326-1440
Mailing address
339 E Maple St
North Canton, OH 44720-2593
Phone (330) 498-8200
Other providers in Kenton, OH
- Deol Dental Kenton LLC
- Herman Deol
- Murlidhar R. Deshmukh
- Betsy Doenges
- James O Doone
- Trevor Downing
- Austin Dumbaugh
- Tracy Dush
- Amy E. Edwards
- Henry Eggers III
All providers in Kenton, OH · Occupational Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.