Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XE0001X | Environmental Modification | 1955 | CO |
N | 225XG0600X | Occupational Therapist - Gerontology | 1955 | CO |
Y | 2251H1300X | Human Factors | 1955 | CO |
Y | 225XH1300X | Human Factors | 1955 | CO |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 1955 | CO |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1955 | CO |
N | 225XP0200X | Occupational Therapist - Pediatrics | 1955 | CO |
N | 225XR0403X | Driving and Community Mobility | 1955 | CO |
NPI | 1962755942 |
---|---|
Provider Name | Benjamin Andrew Mooney |
First Address | Centennial, CO 80122-2184 |
Second Address | Centennial, CO 80122-2184 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 16/10/2012 |