Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | 211168 | TX |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT.0006432 | CO |
NPI | 1235420159 |
---|---|
Provider Name | Carina Langenbach Watson |
First Address | Denver, CO 80210-5105 |
Second Address | Denver, CO 80210-5105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2011 |
Last Update Date | 13/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
149984001 | (05) | TX |
207164901 | (05) | TX |