Individual
JACELYN JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.O.T
Contact information
Practice address
23013 WESTCHESTER BLVD, PORT CHARLOTTE, FL 33980-8448
(941) 625-1220
Mailing address
23013 WESTCHESTER BLVD, PORT CHARLOTTE, FL 33980-8448
(941) 625-1220
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16674
FL
Other
Enumeration date
02/15/2015
Last updated
02/15/2015
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