Individual
MRS. JENNIFER ANN MANDATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD,MED,OTR/L
Contact information
Practice address
6102 GREATWATER DR, WINDERMERE, FL 34786-5600
(689) 207-8112
Mailing address
6102 GREATWATER DR, WINDERMERE, FL 34786-5600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
008652-1
NY
222Q00000X
Developmental Therapist
—
FL
225X00000X
Occupational Therapist
008652-1
NY
225X00000X
Occupational Therapist
011217
OH
225X00000X
Occupational Therapist
Primary
20630
FL
225X00000X
Occupational Therapist
21363
CA
252Y00000X
Early Intervention Provider Agency
—
FL
Other
Enumeration date
11/02/2009
Last updated
10/26/2022
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