Individual
JENNIFER LYNN MAHOVLICH
Active
Individual
JENNIFER LYNN MAHOVLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5780
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1400R
BCBS
NC
01
—
183109
MEDCOST
—
01
—
6400040
UNITED HEALTHCARE
—
05
—
7301843
—
NC
01
—
7981727
AETNA
—
05
—
8300041K
—
NC
Enumeration date
12/12/2006
Last updated
08/19/2009
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