Jackie Lynette Roberson
Occupational Therapist in Pueblo, CO. Individual provider (NPI-1).
NPI number1114484110
StatusActive
Last updated in NPPESDec 27, 2019
Details
- NPI
- 1114484110
- Entity type
- Individual (NPI-1)
- Name
- Jackie Lynette Roberson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2019
- Certification date
- Dec 27, 2019
- Last updated
- Dec 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT.0005855 | CO | Yes |
| 227900000X | Respiratory Therapist, Registered | RTL.0005892 | CO |
Other names
- Jackie Lynette Tijerina (Former Name)
Practice location
3727 Parker BlvdPueblo, CO 81008-2218
Phone 719-585-3400
Mailing address
5302 Artistic CirColorado Springs, CO 80917-2212
Phone 512-567-9565
Other practice locations
8540 Scarborough Dr Ste 200
Colorado Springs, CO 80920-7513
Colorado Springs, CO 80920-7513
Phone 719-630-7500
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All 64 Occupational Therapist providers in Pueblo · All 5,060 providers in Pueblo
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