Healthcare Provider Details

I. General information

NPI: 1699088823
Provider Name (Legal Business Name): JENNIFER HEILSHORN MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER FORCE

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11570 E 126TH ST
FISHERS IN
46037-9592
US

IV. Provider business mailing address

7957 S DATURA ST
LITTLETON CO
80120-4439
US

V. Phone/Fax

Practice location:
  • Phone: 317-579-0166
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number0004354
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: