Individual
JENNIFER ANN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265008
NBCOT
WY
Enumeration date
04/19/2011
Last updated
04/19/2011
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