Provider Demographics
NPI:1164206652
Name:JAYNES, CAROLEE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:CAROLEE
Middle Name:
Last Name:JAYNES
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 SCENIC ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-8971
Mailing Address - Country:US
Mailing Address - Phone:801-209-9070
Mailing Address - Fax:
Practice Address - Street 1:2149 SCENIC ESTATES DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-8971
Practice Address - Country:US
Practice Address - Phone:801-209-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005899225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist