Provider Demographics
NPI:1518220276
Name:LESSMAN, JENNIFER SUE (OTR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUE
Last Name:LESSMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:SUE
Other - Last Name:EDGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:5449 FERRYBOAT CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-7924
Mailing Address - Country:US
Mailing Address - Phone:970-461-8311
Mailing Address - Fax:
Practice Address - Street 1:3307 S COLLEGE AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4196
Practice Address - Country:US
Practice Address - Phone:970-407-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3325225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist