Individual
JENNIFER SUE FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1500 KOENIGSTEIN, NORFOLK, NE 68701
(402) 644-7396
(402) 644-7394
Mailing address
85414 553RD AVE, PIERCE, NE 68767
(308) 325-6536
(308) 995-6587
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
741
NE
225XP0200X
Pediatric Occupational Therapist
741
NE
Other
Enumeration date
08/13/2012
Last updated
10/21/2021
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