Provider Demographics
NPI:1215068648
Name:VELAZCO-LOWE, JENNY (BA)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:VELAZCO-LOWE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 COVE CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-6313
Mailing Address - Country:US
Mailing Address - Phone:513-863-4594
Mailing Address - Fax:866-505-5231
Practice Address - Street 1:5782 OBSERVATION CT
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1472
Practice Address - Country:US
Practice Address - Phone:513-312-3964
Practice Address - Fax:866-505-5231
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 005663225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist