Provider Demographics
NPI:1144701863
Name:DOWNS, JENNA LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN
Last Name:DOWNS
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 1:8 CORNWALL RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:CT
Mailing Address - Zip Code:06754-1715
Mailing Address - Country:US
Mailing Address - Phone:860-600-7529
Mailing Address - Fax:
Practice Address - Street 1:8 CORNWALL RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:CT
Practice Address - Zip Code:06754-1715
Practice Address - Country:US
Practice Address - Phone:860-600-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
CT5029225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060842189OtherORGANIZATION