Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225XE0001X | Environmental Modification | ||
N | 225XF0002X | Feeding, Eating & Swallowing | ||
N | 225XG0600X | Occupational Therapist - Gerontology | ||
N | 225XL0004X | Low Vision | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1275769069 |
---|---|
Provider Name | Kimberly S. Mills |
First Address | Fort Collins, CO 80528-7050 |
Second Address | Fort Collins, CO 80528-7050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2009 |
Last Update Date | 07/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2145 | STATE LICENSE NUMBERS (01) | CO |
OTR-732 | STATE LICENSE NUMBERS (01) | WY |