Individual
JYOTSNA R SUPNEKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR, CHT
Contact information
Practice address
3465 BOX HILL CORPORATE CENTER DR, SUITE G, ABINGDON, MD 21009-1261
(410) 569-4806
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
06635
MD
225X00000X
Occupational Therapist
46TR00154000
NJ
225XH1200X
Hand Occupational Therapist
46TR00154000
NJ
Other
Enumeration date
05/19/2007
Last updated
07/18/2011
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