Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
N | 225XF0002X | Feeding, Eating & Swallowing | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1821194481 |
---|---|
Provider Name | Gina Luck |
First Address | Frisco, CO 80443-2241 |
Second Address | Frisco, CO 80443-2241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 18/11/2015 |