Healthcare Provider Details

I. General information

NPI: 1831026665
Provider Name (Legal Business Name): JEANETTE FRANCIS FARSON-LOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANETTE FRANCIS FARSONLOWELL

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 COURT ST
PUEBLO CO
81003-2427
US

IV. Provider business mailing address

2403 COURT ST
PUEBLO CO
81003-2427
US

V. Phone/Fax

Practice location:
  • Phone: 405-436-8363
  • Fax:
Mailing address:
  • Phone: 405-436-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-466858
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: