Individual
MRS. JENNIFER ANN PENROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
151 COUNTRY MEADOWS BLVD, WAXAHACHIE, TX 75165-7811
(972) 937-1560
Mailing address
2401 FM 1181, ENNIS, TX 75119-5571
(972) 979-1535
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208406
TX
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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