Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | AA484873 | CO |
NPI | 1427310382 |
---|---|
Provider Name | Cindy Kay Greenfield |
First Address | Timnath, CO 80547-0391 |
Second Address | Fort Collins, CO 80525-9401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 15/06/2012 |