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Contact Information

JACKIE L ROBERSON
3727 PARKER BLVD
PUEBLO, CO81008-2218
 Phone: 719-585-3400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Respiratory Therapist, Registered

227900000X
Indicates primary specialty

NPI Profile & details for JACKIE L ROBERSON · (Female)

NPI # 1114484110
Status Active
Credentials
Entity Individual
Enumeration date 02/26/2019
Last updated 12/27/2019 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CO License # OT.0005855
  • CO License # RTL.0005892
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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