Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 0002744 | CO |
N | 225XE0001X | Environmental Modification | OT 0002744 | CO |
NPI | 1437597143 |
---|---|
Provider Name | Michelle Purcell |
First Address | Fort Collins, CO 80525-8900 |
Second Address | Fort Collins, CO 80525-8900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 05/06/2013 |