Provider Demographics
NPI:1285109843
Name:VASIU, JENNY JUSTINA
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:JUSTINA
Last Name:VASIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 22ND PL SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6314
Mailing Address - Country:US
Mailing Address - Phone:239-784-0119
Mailing Address - Fax:
Practice Address - Street 1:7900 ARLINGTON CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-3218
Practice Address - Country:US
Practice Address - Phone:239-784-0119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant