Jenniffer Tacker, COTA
Individual provider Active NPI Occupational Therapy Assistant · Lorena, TX
NPI 1972908903 · NPPES record last updated Nov 4, 2014
Key facts
- NPI
- 1972908903
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 212946 (TX)
- Practice address
- 768 E Leona Pkwy
Lorena, TX 76655-4207 - Phone
- (254) 747-0574
- NPI assigned
- Nov 4, 2014
- 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 |
|---|---|---|---|
| 212946 | TX | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 212946 | TX | Yes |
Addresses
Primary practice location
768 E Leona Pkwy
Lorena, TX 76655-4207
Mailing address
768 E Leona Pkwy
Lorena, TX 76655-4207
Phone (254) 747-0574
Other providers in Lorena, TX
- Lorenzo Sanchez
- Brenna Leigh Sanford
- Marissa Jane Hostin Smith
- Speech Is a Blast PLLC
- Tanis Stewart
- Lisa Lyn Thompson
- Brian Tigelaar
- Unkee Monkee Enterprises LLC
- Elyse Anne Vaughn
- Brian Dean Westfall
All providers in Lorena, TX · Occupational Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2014. 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.