Provider Demographics
NPI:1982724282
Name:KINTNER, JEANELLE (MSOT)
Entity type:Individual
Prefix:
First Name:JEANELLE
Middle Name:
Last Name:KINTNER
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-5336
Mailing Address - Country:US
Mailing Address - Phone:720-898-5663
Mailing Address - Fax:720-898-5663
Practice Address - Street 1:6608 ALKIRE CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-2125
Practice Address - Country:US
Practice Address - Phone:720-303-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004015191225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist