Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2963 | CO |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2963 | CO |
NPI | 1336336346 |
---|---|
Provider Name | Laura Jean Watrous |
First Address | Vail, CO 81658-7520 |
Second Address | Eagle, CO 81631-6779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 07/12/2021 |