Provider Demographics
NPI:1003079336
Name:BLYER, JENNIFER HOLLAND (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:HOLLAND
Last Name:BLYER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 HEARTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-7373
Mailing Address - Country:US
Mailing Address - Phone:603-674-5260
Mailing Address - Fax:
Practice Address - Street 1:1386 NH ROUTE 140
Practice Address - Street 2:
Practice Address - City:GILMANTON IRON WORKS
Practice Address - State:NH
Practice Address - Zip Code:03837-4630
Practice Address - Country:US
Practice Address - Phone:603-364-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1934225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist