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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. JACKE KHANTIVONG, OTR/L

Active Sole Proprietor

MS. JACKE KHANTIVONG, OTR/L is a Occupational Therapist healthcare provider located in DENVER, Colorado. NPI 1619114485 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · DENVER, CO

Registration Details

NPI Number
1619114485
Provider Type
Individual
Gender
Female
NPI Issued
Jan 14, 2009 (17.578284192642 yrs)
Last Updated
Aug 31, 2010
Licenses
003380 (CT)
2191 (CO)
Sole Proprietor
Yes

Practice Information

Address
1247 S RACE ST
DENVER, CO, 802101817
Browse CO providers · Browse ZIP 80210
Phone
8603061384
Primary Specialty
Occupational Therapist
225X00000X
Additional Specialty
Occupational Therapist

Other Occupational Therapist Providers in DENVER, CO

Name Credential NPI
MS. DENISE CAROL ORIN OTR 1538158308
MR. WILLIAM M SMITHAM OTR 1073502878
MRS. CYNTHIA CANO OTR 1821079468
VICKIE L HEALY OT 1952382574
MR. MATTHEW ALAN REMBAUM OT 1841277860
NANCY COLLINS SIMONE OTR 1487625026
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.