Individual
JENNIFER L GENDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L, SCLV
Contact information
Practice address
3309 WELLINGMOOR AVE, LOUISVILLE, KY 40218
(630) 712-7167
Mailing address
3309 WELLINGMOOR AVE, LOUISVILLE, KY 40218-1028
(630) 712-7167
Taxonomy
Speciality
Code
Description
License number
State
225XL0004X
Low Vision Occupational Therapist
Primary
131122
KY
225XL0004X
Low Vision Occupational Therapist
T02895
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100225350
—
KY
Enumeration date
02/28/2011
Last updated
03/21/2019
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