Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | ||
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | CO | |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1831609726 |
---|---|
Provider Name | Edith L Haverland |
First Address | Centennial, CO 80112-2657 |
Second Address | Englewood, CO 80110-2199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2017 |
Last Update Date | 04/10/2017 |