Healthcare Provider Details

I. General information

NPI: 1588372932
Provider Name (Legal Business Name): JAIMA ROSE HAJEK BCBA, SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 BLAKE ST STE 220
DENVER CO
80205-4889
US

IV. Provider business mailing address

45 S GROVE ST
DENVER CO
80219-2016
US

V. Phone/Fax

Practice location:
  • Phone: 720-524-3975
  • Fax:
Mailing address:
  • Phone: 224-567-2799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number24391950
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-61925
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: