Provider Demographics
NPI:1699498170
Name:HUGHES, JENNIFER C (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:C
Last Name:HUGHES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:B
Other - Last Name:CODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8555 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-8924
Mailing Address - Country:US
Mailing Address - Phone:601-938-9909
Mailing Address - Fax:
Practice Address - Street 1:6600 POPLAR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1105
Practice Address - Country:US
Practice Address - Phone:601-482-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT2968225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist