Individual
MS. JENNIE DESRAVINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4284 SW 161ST PL, MIAMI, FL 33185-3826
(786) 208-2814
(305) 228-6251
Mailing address
244 NW 42ND ST, MIAMI, FL 33127-2836
(305) 469-3575
(305) 228-6251
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 11023
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891607100
—
FL
Enumeration date
04/06/2007
Last updated
07/09/2007
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