Individual
STEPHANIE JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1003 OSPREY DR, SHREVEPORT, LA 71106-8352
(318) 453-8112
Mailing address
1003 OSPREY DR, SHREVEPORT, LA 71106-8352
(318) 453-8112
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
200874
LA
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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