Provider Demographics
NPI:1386029478
Name:WARNER, JAMIE REBECCA (COTA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:REBECCA
Last Name:WARNER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 E GIRARD PL
Mailing Address - Street 2:528A
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-9111
Mailing Address - Country:US
Mailing Address - Phone:720-560-4774
Mailing Address - Fax:
Practice Address - Street 1:1492 E GIRARD PL
Practice Address - Street 2:528A
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-9111
Practice Address - Country:US
Practice Address - Phone:720-560-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0000644174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist