Provider Demographics
NPI:1427599448
Name:ESPARSEN, JEANETTE ANN-JANES (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:ANN-JANES
Last Name:ESPARSEN
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 1:4445 N CAREFREE CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-2113
Mailing Address - Country:US
Mailing Address - Phone:719-337-7408
Mailing Address - Fax:
Practice Address - Street 1:11721 ALLENDALE DR.
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-6834
Practice Address - Country:US
Practice Address - Phone:719-337-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0004924225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist