Individual
MS. PENNY LAINE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1708 E CHEVY CHASE DR APT 5, GLENDALE, CA 91206-2802
(818) 422-8019
Mailing address
1708 E CHEVY CHASE DR APT 5, GLENDALE, CA 91206-2802
(818) 422-8019
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2953
CA
Other
Enumeration date
05/18/2019
Last updated
05/18/2019
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