Provider Demographics
NPI:1760293138
Name:BAUER, JENNIFER JOAN (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JOAN
Last Name:BAUER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2415
Mailing Address - Country:US
Mailing Address - Phone:732-619-9668
Mailing Address - Fax:
Practice Address - Street 1:805 GROVE ST
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-2415
Practice Address - Country:US
Practice Address - Phone:732-619-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00308500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist