Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5728 | CO |
NPI | 1104977727 |
---|---|
Provider Name | Laura Louise Koenig |
First Address | Highlands Ranch, CO 80129-2266 |
Second Address | Highlands Ranch, CO 80129-2266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 09/04/2019 |