Healthcare Provider Details

I. General information

NPI: 1447048442
Provider Name (Legal Business Name): GABRIELA MERIEL JORDAN MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 RALEIGH ST STE 210
DENVER CO
80204-1497
US

IV. Provider business mailing address

1217 S GREELEY HWY STE A
CHEYENNE WY
82007-3063
US

V. Phone/Fax

Practice location:
  • Phone: 303-458-9660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberOT.0008794
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0008794
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: