Provider Demographics
NPI:1992973069
Name:OTTERSBERG-SMITH, JANET LOUISE (OTR)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LOUISE
Last Name:OTTERSBERG-SMITH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-1043
Mailing Address - Country:US
Mailing Address - Phone:719-406-8777
Mailing Address - Fax:
Practice Address - Street 1:1220 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-1043
Practice Address - Country:US
Practice Address - Phone:719-406-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist