Individual
JENNIFER JOY WHITCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1705 COPE AVE E, SUITE G, MAPLEWOOD, MN 55109
(651) 773-0354
Mailing address
1479 HURON ST, SAINT PAUL, MN 55108-2316
(612) 916-0324
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
102863
MN
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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