Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1537 | CO |
N | 225XG0600X | Occupational Therapist - Gerontology | 1537 | CO |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1537 | CO |
NPI | 1518192392 |
---|---|
Provider Name | Mrs. Carol Jo Dorsey |
First Address | Fort Collins, CO 80526-2279 |
Second Address | Fort Collins, CO 80526-2279 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 21/05/2009 |