Individual
ELIZABETH JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1102 WINKLER AVE, KILLEEN, TX 76542
(254) 634-8505
(254) 519-3477
Mailing address
605 DONNIE AVE, KILLEEN, TX 76541-8918
(254) 634-8505
(254) 781-4312
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
110264
TX
225XP0200X
Pediatric Occupational Therapist
110264
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161316801
—
TX
Enumeration date
01/10/2007
Last updated
09/19/2023
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