Provider Demographics
NPI:1396149589
Name:ALDINGER, JENNIFER (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:ALDINGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2558 WILSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:PA
Mailing Address - Zip Code:16938-9426
Mailing Address - Country:US
Mailing Address - Phone:570-353-7185
Mailing Address - Fax:
Practice Address - Street 1:37 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1857
Practice Address - Country:US
Practice Address - Phone:570-723-0834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-16
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006814224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant