Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA.00001488 | CO |
NPI | 1003561663 |
---|---|
Provider Name | Devin Marina Coffin |
First Address | Fountain, CO 80817-1581 |
Second Address | Colorado Springs, CO 80919-2726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2022 |
Last Update Date | 12/02/2022 |