Provider Demographics
NPI:1750745295
Name:SAJBEL, JENNIFER O'NEIL (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:O'NEIL
Last Name:SAJBEL
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:O'NEIL
Other - Last Name:SAJBEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:1901 WINTERBERRY WAY UNIT C
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1953
Mailing Address - Country:US
Mailing Address - Phone:970-222-7923
Mailing Address - Fax:
Practice Address - Street 1:1901 WINTERBERRY WAY UNIT C
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1953
Practice Address - Country:US
Practice Address - Phone:970-222-7923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY184133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
15894OtherREGISTERED DIETITIAN
WY184OtherWYOMING DIETITIAN LICENSE