Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | AA331363 | CO |
NPI | 1902863186 |
---|---|
Provider Name | Mrs. Christy M Dittmar |
First Address | Fort Collins, CO 80524-3926 |
Second Address | Fort Collins, CO 80524-3926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2006 |
Last Update Date | 26/12/2007 |