Individual
MS. JENNIFER ELEANOR KOFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
140 N HILLTOP DRIVE, TITUSVILLE, FL 32796
(321) 225-9540
Mailing address
140 N HILLTOP DRIVE, TITUSVILLE, FL 32796
(321) 225-9540
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10448
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10448
OTA LICENSE
FL
Enumeration date
04/08/2011
Last updated
04/08/2011
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