Jennifer Gandolfo

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

JENNIFER GANDOLFO

Practice address

710 Abbottsford CT.
Lake St. Louis, MO 63367

Phone

(314) 479-0306

NPI assigned

Mar 21, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer M Gandolfo, OTR/L

Title

Occupational Therapist

Phone

(314) 440-8985

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1710349642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 ABBOTTSFORD CT.",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "314-479-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 ABBOTTSFORD CT.",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "314-479-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER GANDOLFO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "GANDOLFO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "314-440-8985",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Umesh C. Inampudi, M.D.
• Inclusive Clinical Counseling
• Jack D. Griffin, Jr. D.M.D., Lake St. Louis, LLC
• James H Hinrichs MD LLC
• Jeffrey S Glaser MD Facs LLC
• Johnsons Enterprises Inc. (Senior Helpers)
• Stacey Anne Juengst, LPC
• Katrina Juskenas, DPT, PT
• Gihan A Kader, MD
• Claire Kelly

• Early Intervention Provider Agency in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• Early Intervention Provider Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.