Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Jacke Khantivong, OTR/L

Individual provider Occupational Therapist · NPI 1619114485

MS. Jacke Khantivong, OTR/L is an Occupational Therapist in Denver, Colorado. Practices as a sole proprietor. Licensed in Colorado and Connecticut.

Licensed in
CO, CT
In the registry since
2009
Specialties on file
2
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

1247 S Race St
Denver, CO 80210-1817
Phone: (860) 306-1384
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 2191 (CO)
Occupational Therapist Taxonomy 225X00000X · Licence 003380 (CT)

Record details

NPI number1619114485
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedJanuary 14, 2009
Last updated in NPPESAugust 31, 2010

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