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Individual

MRS. JENNIFER R JERDEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.T.R.

Contact information

Practice address
4308 WHITE OAK LN, SHEBOYGAN, WI 53083-2178
(920) 457-4566
Mailing address
4308 WHITE OAK LN, SHEBOYGAN, WI 53083-2178
(920) 457-4566

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2436-026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40822100
WI
Enumeration date
04/04/2008
Last updated
04/04/2008
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