Provider Demographics
NPI:1861074551
Name:RADMILOVIC, JESSICA ANN (MS, CTRS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:RADMILOVIC
Suffix:
Gender:F
Credentials:MS, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 E. FAIRMOUNT DR
Mailing Address - Street 2:APT 1312
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230
Mailing Address - Country:US
Mailing Address - Phone:510-517-1979
Mailing Address - Fax:
Practice Address - Street 1:8155 E. FAIRMOUNT DR
Practice Address - Street 2:APT 1312
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230
Practice Address - Country:US
Practice Address - Phone:510-517-1979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist