Provider Demographics
NPI:1760872832
Name:JENSEN, DANIELLE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:JENSEN
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 1:30772 SOUTHVIEW DR STE 140
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-2214
Mailing Address - Country:US
Mailing Address - Phone:303-704-4578
Mailing Address - Fax:
Practice Address - Street 1:30772 SOUTHVIEW DR STE 140
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-2214
Practice Address - Country:US
Practice Address - Phone:303-704-4578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
CO.0005999225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO.0005999OtherCOLORADO OFFICE OF OCCUPATIONAL THERAPY
334815OtherNATIONAL BOARD CERTIFICATION IN OCCUPATIONAL THERAPY