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General NPI Number Information
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NPI Number | 1811456452
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Entity Type | Individual
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Provider Name | JENNA CARLSON
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Gender | Female
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 1500 LITTLE RAVEN ST
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City | DENVER
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State | CO
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Zip | 80202-6248
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Country | US
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Telephone | 720-360-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 8143 STETSON RD
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City | PARKER
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State | CO
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Zip | 80134-5832
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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