Provider Demographics
NPI:1962783746
Name:PREASTER, JONNAE MCEADY (MHS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:JONNAE
Middle Name:MCEADY
Last Name:PREASTER
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:MS
Other - First Name:JONNAE
Other - Middle Name:LASHAWN
Other - Last Name:MCEADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS,OTR/L
Mailing Address - Street 1:910 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6810
Mailing Address - Country:US
Mailing Address - Phone:904-360-7022
Mailing Address - Fax:
Practice Address - Street 1:910 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6810
Practice Address - Country:US
Practice Address - Phone:904-360-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12403225X00000X
GAOT004886174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist