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Individual

JENNIFER LYNN MAHOVLICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
1995 E CORNELIUS HARNETT BLVD, LILLINGTON, NC 27546-8276
(910) 814-0880
Mailing address
1995 E CORNELIUS HARNETT BLVD, LILLINGTON, NC 27546-8276
(910) 814-0880

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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