Provider Demographics
NPI:1528795770
Name:COHEN, JESSICA LYNN (MSC, OTR/L)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 CRAWFORD ST APT 613
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6841
Mailing Address - Country:US
Mailing Address - Phone:636-399-6414
Mailing Address - Fax:
Practice Address - Street 1:5757 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1514
Practice Address - Country:US
Practice Address - Phone:713-977-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122659225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics