Individual
JED JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1216 HILLCREST DR, SHERMAN, TX 75092-5507
(903) 893-7457
(903) 893-6671
Mailing address
1216 HILLCREST DR, SHERMAN, TX 75092-5507
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105389
STATE ID
TX
01
—
8T5229
BLUECROSS BLUESHIELD
TX
Enumeration date
02/12/2007
Last updated
07/08/2007
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