Provider Demographics
NPI:1487973186
Name:GOLINSKI, JENNIFER MARY (OT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARY
Last Name:GOLINSKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18170 N 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-0866
Mailing Address - Country:US
Mailing Address - Phone:623-374-6660
Mailing Address - Fax:
Practice Address - Street 1:18170 N 91ST AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-0866
Practice Address - Country:US
Practice Address - Phone:623-374-6660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4715225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist