Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0000846 | CO |
NPI | 1003368507 |
---|---|
Provider Name | Michiko Koyoshi |
First Address | Denver, CO 80211-1941 |
Second Address | Greenwood Village, CO 80111-2905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2016 |
Last Update Date | 01/11/2016 |