Individual
JENNIFER A FASNACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
818 W 1ST ST, SUITE 301, MONTICELLO, IA 52310-1307
(319) 465-3059
(319) 465-4070
Mailing address
818 W 1ST ST, SUITE 301, MONTICELLO, IA 52310-1307
(319) 465-3059
(319) 465-4070
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01180
IA
Other
Enumeration date
02/28/2007
Last updated
10/30/2012
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