Provider Demographics
NPI:1558134056
Name:HUNSICKER, JAIMIE LISA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JAIMIE
Middle Name:LISA
Last Name:HUNSICKER
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 1:8205 BARN SWALLOW GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-9457
Mailing Address - Country:US
Mailing Address - Phone:719-351-4478
Mailing Address - Fax:
Practice Address - Street 1:1820 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-1152
Practice Address - Country:US
Practice Address - Phone:719-391-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0002314225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics