Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT.0004262 | CO |
NPI | 1528453149 |
---|---|
Provider Name | Catherine Harrell |
First Address | Boulder, CO 80305-5408 |
Second Address | Boulder, CO 80305-5408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 31/03/2015 |