Provider Demographics
NPI:1871611525
Name:ANDURI, JEANNE MARIE (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:MARIE
Last Name:ANDURI
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1051
Mailing Address - Street 2:
Mailing Address - City:FAIRPLAY
Mailing Address - State:CO
Mailing Address - Zip Code:80440-1051
Mailing Address - Country:US
Mailing Address - Phone:719-836-2852
Mailing Address - Fax:
Practice Address - Street 1:2900 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-6029
Practice Address - Country:US
Practice Address - Phone:303-773-1034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA475467225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist