Provider Demographics
NPI:1871039313
Name:VENNART, JENNIFER L (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:VENNART
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 W 155TH PL
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3628
Mailing Address - Country:US
Mailing Address - Phone:913-669-4652
Mailing Address - Fax:
Practice Address - Street 1:6210 W 155TH PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3628
Practice Address - Country:US
Practice Address - Phone:913-669-4652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02577225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist