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Individual
JENNIFER STANLEY
Active
Individual
JENNIFER STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, OT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT24241
FL
225X00000X
Occupational Therapist
OT12720
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376593053
GROUP PRACTICE NPI
FL
01
—
169704439
MEDICARE PTAN
FL
Enumeration date
09/08/2008
Last updated
09/08/2008
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