Provider Demographics
NPI:1609078872
Name:LEMASTER, JENINE A (OTR-L)
Entity Type:Individual
Prefix:
First Name:JENINE
Middle Name:A
Last Name:LEMASTER
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 1:22058 R RD
Mailing Address - Street 2:
Mailing Address - City:CEDAREDGE
Mailing Address - State:CO
Mailing Address - Zip Code:81413-8283
Mailing Address - Country:US
Mailing Address - Phone:970-856-7905
Mailing Address - Fax:
Practice Address - Street 1:5814 HIGHWAY 348
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425-9714
Practice Address - Country:US
Practice Address - Phone:970-323-5400
Practice Address - Fax:970-323-9090
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1052910225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01654125OtherRAILROAD WORKERS MEDICARE FOR DREAM CATCHER THERAPY
CO497566ZUR8OtherMEDICARE B PTAN FOR DREAM CATCHER THERAPY
CO46536051Medicaid