Provider Demographics
NPI:1962802629
Name:COYNE, JENNIFER ANN (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:COYNE
Suffix:
Gender:F
Credentials:MS, OTR/L
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Mailing Address - Street 1:2301 COLUMBIA PIKE SUITE 125
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4453
Mailing Address - Country:US
Mailing Address - Phone:202-544-5439
Mailing Address - Fax:
Practice Address - Street 1:2301 COLUMBIA PIKE APT 125
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4453
Practice Address - Country:US
Practice Address - Phone:571-527-0818
Practice Address - Fax:202-379-1797
Is Sole Proprietor?:No
Enumeration Date:2014-09-01
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010001338225XP0200X
VA0119007407225XP0200X
CA14499225XP0200X
VA9315225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics