Provider Demographics
NPI:1578763074
Name:PETERMAN, JENNIFER L (COTA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:PETERMAN
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 1:16913 E STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1915
Mailing Address - Country:US
Mailing Address - Phone:303-478-5481
Mailing Address - Fax:
Practice Address - Street 1:16913 E STANFORD AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1915
Practice Address - Country:US
Practice Address - Phone:303-478-5481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant