Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT.0005015 | CO |
NPI | 1376141796 |
---|---|
Provider Name | Ashley Peter |
First Address | Englewood, CO 80113-1723 |
Second Address | Thornton, CO 80229-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2020 |
Last Update Date | 16/10/2020 |