Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 2673 | CA |
N | 2251E1200X | Ergonomics | 0003370 | CO |
N | 225XE1200X | Ergonomics | 0003370 | CO |
Y | 225XH1200X | Occupational Therapist - Hand | 0003370 | CO |
NPI | 1134277437 |
---|---|
Provider Name | Mrs. Rebecca Nicoll Jensen |
First Address | Boulder, CO 80304-3612 |
Second Address | Boulder, CO 80304-3612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 01/04/2020 |