Individual
JENNIFER KEMPHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-3726
Mailing address
112 FREEPORT CT, HUBERT, NC 28539-4103
(309) 269-1634
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
004975
IL
224Z00000X
Occupational Therapy Assistant
057004975
IL
224Z00000X
Occupational Therapy Assistant
Primary
8766
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057004975
STATE OT LICENSE
IL
01
—
311115
NATIONAL CERTIFICATION NBCOT
—
01
—
8766
STATE LICENSE
NC
Enumeration date
01/16/2019
Last updated
01/16/2019
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