Provider Demographics
NPI:1528626827
Name:STUDEE, JADE ELIZABETH (OTR/L)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:ELIZABETH
Last Name:STUDEE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1684 RIVERSIDE AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1320
Mailing Address - Country:US
Mailing Address - Phone:262-353-6851
Mailing Address - Fax:
Practice Address - Street 1:2501 WALNUT ST STE 102
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5752
Practice Address - Country:US
Practice Address - Phone:303-442-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005787225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist