Jennifer Lynn Wallace
Occupational Therapy Assistant
4009 Riverdell Dr
Wentzville
, Missouri 63385-4775
Jennifer Lynn Wallace
Occupational Therapy Assistant
4009 Riverdell Dr
Wentzville
, Missouri 63385-4775
(636) 734-9985
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About
Features
Specialties
- Occupational Therapy Assistant
Languages spoken
- English
Location
First Address
- Jennifer Lynn Wallace
- 4009 Riverdell Dr
- Wentzville, MO
- Zip : 63385-4775
- Phone : (636) 734-9985
Second Address
- Jennifer Lynn Wallace
- 4009 Riverdell Dr
- Wentzville, MO
- Zip : 63385-4775
- Phone : (636) 734-9985
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 2010026736 | MO |
National Provider Identifier
| NPI | 1972264273 |
|---|---|
| Provider Name | Jennifer Lynn Wallace |
| First Address | Wentzville, MO 63385-4775 |
| Second Address | Wentzville, MO 63385-4775 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/01/2022 |
| Last Update Date | 07/01/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.