Provider Demographics
NPI:1376694109
Name:JONES, KAREN KAY (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 ALABASTER WAY
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-9470
Mailing Address - Country:US
Mailing Address - Phone:970-587-5547
Mailing Address - Fax:
Practice Address - Street 1:611 KORTE WAY
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6366
Practice Address - Country:US
Practice Address - Phone:303-776-1373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
992259225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23471263Medicaid