Provider Demographics
NPI:1528291465
Name:DION, JENNIFER A (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:DION
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:POLLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4 LARK LN
Mailing Address - Street 2:
Mailing Address - City:ASSONET
Mailing Address - State:MA
Mailing Address - Zip Code:02702-1630
Mailing Address - Country:US
Mailing Address - Phone:508-245-2508
Mailing Address - Fax:
Practice Address - Street 1:4263 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-1714
Practice Address - Country:US
Practice Address - Phone:508-245-2508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02958225100000X
MA18706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA18706OtherPT LICENSE