Provider Demographics
NPI:1487493227
Name:ROGERS, JESSICA JOYCE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:JOYCE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WHEATON PL
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2713
Mailing Address - Country:US
Mailing Address - Phone:201-394-4847
Mailing Address - Fax:
Practice Address - Street 1:123 N WACKER DR STE 1150
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1744
Practice Address - Country:US
Practice Address - Phone:866-600-7598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-2501225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics