Provider Demographics
NPI:1871949479
Name:DANAR, JENNIFER ANNE JAMIAS (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNIFER ANNE
Middle Name:JAMIAS
Last Name:DANAR
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 1:4922 LASALLE RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3302
Mailing Address - Country:US
Mailing Address - Phone:301-864-2333
Mailing Address - Fax:877-828-2060
Practice Address - Street 1:12325 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2957
Practice Address - Country:US
Practice Address - Phone:301-622-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07571225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1447657507OtherNPI TYPE 2/ORGANIZATION NPI
MD4374045-00Medicaid
MD337362Medicare PIN