Provider Demographics
NPI:1053988030
Name:OZUG, JENNY KATE (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:KATE
Last Name:OZUG
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 1:64 CHARLOTTE WHITE ROAD EXT UNIT B
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4332
Mailing Address - Country:US
Mailing Address - Phone:508-730-8865
Mailing Address - Fax:
Practice Address - Street 1:242 WAREHAM RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1163
Practice Address - Country:US
Practice Address - Phone:617-302-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13740225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty