Provider Demographics
NPI:1043712201
Name:HENZE, JEAN LINDA (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:LINDA
Last Name:HENZE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15530 E BRONCOS PKWY UNIT 100
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7111
Mailing Address - Country:US
Mailing Address - Phone:720-432-2860
Mailing Address - Fax:720-789-2210
Practice Address - Street 1:15530 E BRONCOS PKWY UNIT 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-7111
Practice Address - Country:US
Practice Address - Phone:720-432-2860
Practice Address - Fax:720-789-2210
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006426225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist