Provider Demographics
NPI:1427243096
Name:JANOSKO, JENNIFER LOUISE (OTR)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOUISE
Last Name:JANOSKO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LOUISE
Other - Last Name:JANOSKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:11825 WELLER HILL DR
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:MD
Mailing Address - Zip Code:21770-9453
Mailing Address - Country:US
Mailing Address - Phone:301-865-0853
Mailing Address - Fax:
Practice Address - Street 1:333 S SETON AVE
Practice Address - Street 2:
Practice Address - City:EMMITSBURG
Practice Address - State:MD
Practice Address - Zip Code:21727-9239
Practice Address - Country:US
Practice Address - Phone:301-447-7022
Practice Address - Fax:301-447-7140
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04593225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist