Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA.0001154 | CO |
NPI | 1023686094 |
---|---|
Provider Name | Aria Eubanks |
First Address | Aurora, CO 80247-6201 |
Second Address | Brighton, CO 80601-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2021 |
Last Update Date | 15/06/2021 |