Provider Demographics
NPI:1548044571
Name:WEIBLE, JAIME (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:WEIBLE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 WOLFF ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2827
Mailing Address - Country:US
Mailing Address - Phone:913-991-8824
Mailing Address - Fax:
Practice Address - Street 1:7405 W ARIZONA PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5416
Practice Address - Country:US
Practice Address - Phone:303-720-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO497318225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist