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Individual

JENNIFER HEROLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
3 LAUREL LN, PALM COAST, FL 32137-2632
(440) 479-4308
Mailing address
3 LAUREL LN, PALM COAST, FL 32137-2632
(440) 479-4308

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
006805
GA
225X00000X
Occupational Therapist
Primary
20139
FL
225X00000X
Occupational Therapist
31006948A
IN
225X00000X
Occupational Therapist
4354
SC
225X00000X
Occupational Therapist
5201010301
MI
225X00000X
Occupational Therapist
60881087
WA
225X00000X
Occupational Therapist
6315
TN
225X00000X
Occupational Therapist
7593
OH

Other

Enumeration date
11/04/2024
Last updated
11/04/2024
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