Individual
MRS. JENIFER A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
598 INDIAN TRAIL RD S STE 141, INDIAN TRAIL, NC 28079-8689
(704) 975-7008
(704) 821-0750
Mailing address
598 INDIAN TRAIL RD S STE 141, INDIAN TRAIL, NC 28079-8689
(704) 975-7008
(704) 821-0750
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5635
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103C
BCBS
NC
01
—
64-42619
UHC
NC
05
—
7301861
—
NC
Enumeration date
03/17/2006
Last updated
07/17/2009
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