Provider Demographics
NPI:1972750818
Name:BUXTON, JENNIFER KARA (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KARA
Last Name:BUXTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KARA
Other - Last Name:SOLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ORR/L
Mailing Address - Street 1:2985 MATTHEW LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-5722
Mailing Address - Country:US
Mailing Address - Phone:770-676-9230
Mailing Address - Fax:
Practice Address - Street 1:2985 MATTHEW LN
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-5722
Practice Address - Country:US
Practice Address - Phone:770-676-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002494225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics