Provider Demographics
NPI:1053534073
Name:WINKLER, JESSICA L (OTR)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:WINKLER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E KINGS HWY
Mailing Address - Street 2:#206
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-3434
Mailing Address - Country:US
Mailing Address - Phone:856-340-8455
Mailing Address - Fax:
Practice Address - Street 1:2305 RANCOCAS RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4113
Practice Address - Country:US
Practice Address - Phone:609-747-8619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00359600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist