National Provider Identifier Database

KENDRA K JACK, OTR/L – NPI #1447668009
Children


Contact Information

KENDRA K JACK, OTR/L
2400 CLERMONT CENTER DR
BATAVIA, OH45103-1990
Phone: 513-735-8300
Fax:
Website:
Specialty Taxonomy Code
* Children 283XC2000X

* Indicates primary specialty

NPI Profile & details for KENDRA K JACK

NPI Number 1447668009
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 07/28/2014
Last updated 08/19/2021 - About 5 years ago
Sole proprietor1 Yes
Identifiers
  • IL License #: 056.009954
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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