Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 3590 | TN |
NPI | 1164448700 |
---|---|
Provider Name | Leslie Sutton |
First Address | Fort Collins, CO 80525-7662 |
Second Address | Fort Collins, CO 80525-7662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/03/2021 |