Provider Demographics
NPI:1346495447
Name:JONELL, REBECCA JEAN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JEAN
Last Name:JONELL
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 1:3455 S CORONA ST
Mailing Address - Street 2:ENGLEWOOD MERIDIAN RETIREMENT COMMUNITY
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2810
Mailing Address - Country:US
Mailing Address - Phone:303-761-0300
Mailing Address - Fax:303-781-0073
Practice Address - Street 1:3455 S CORONA ST
Practice Address - Street 2:ENGLEWOOD MERIDIAN RETIREMENT COMMUNITY
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2810
Practice Address - Country:US
Practice Address - Phone:303-761-0300
Practice Address - Fax:303-781-0073
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.002287225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2397OtherREGISTRATION