Provider Demographics
NPI:1124117619
Name:PALMER, JENNIFER LORI (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LORI
Last Name:PALMER
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:VT
Mailing Address - Zip Code:05495-8042
Mailing Address - Country:US
Mailing Address - Phone:802-338-2622
Mailing Address - Fax:
Practice Address - Street 1:192 TILLEY DR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-4440
Practice Address - Country:US
Practice Address - Phone:802-847-7910
Practice Address - Fax:802-847-6987
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0720000501225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand