Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 225XPOO19X | CO |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT-1547 | CO |
NPI | 1346483054 |
---|---|
Provider Name | Diane Gilbert |
First Address | Parker, CO 80138-8277 |
Second Address | Parker, CO 80138-8277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 10/04/2009 |