Individual
KELLY MARIE JENEUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(863) 617-9400
(863) 688-9858
Mailing address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(863) 617-9400
(863) 688-9858
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12929
FL
225X00000X
Occupational Therapist
4519-026
WI
225X00000X
Occupational Therapist
5201006919
MI
225X00000X
Occupational Therapist
792
HI
225X00000X
Occupational Therapist
9173
CA
Other
Enumeration date
05/31/2007
Last updated
10/22/2013
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