Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XF0002X | Feeding, Eating & Swallowing | 0004034 | CO |
N | 225XP0200X | Occupational Therapist - Pediatrics | 0004034 | CO |
NPI | 1063762920 |
---|---|
Provider Name | Kaitlyn Anne Cavanaugh |
First Address | Aurora, CO 80015-7064 |
Second Address | Aurora, CO 80015-7064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2012 |
Last Update Date | 06/07/2016 |