Individual
JENNA VANDEVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
950 YOUNGSTOWN WARREN RD STE A, NILES, OH 44446-4626
(330) 505-1606
Mailing address
1353 WESTOVER DR SE, WARREN, OH 44484-2814
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA007499
OH
224Z00000X
Occupational Therapy Assistant
—
OH
2255A2300X
Athletic Trainer
OTA007499
OH
Other
Enumeration date
11/13/2019
Last updated
01/03/2023
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