Healthcare Provider Details

I. General information

NPI: 1396270922
Provider Name (Legal Business Name): SARAH JASSO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 04/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S ADAMS ST
DENVER CO
80209-2908
US

IV. Provider business mailing address

1524 S ACOMA ST
DENVER CO
80223-3601
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-1146
  • Fax:
Mailing address:
  • Phone: 630-207-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0005006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: