Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT.0006913 | CO |
NPI | 1679247753 |
---|---|
Provider Name | Aubriel Joanna Wooley |
First Address | Boulder, CO 80304-1031 |
Second Address | Louisville, CO 80027-2325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2021 |
Last Update Date | 03/08/2021 |