Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0005538 | CO |
NPI | 1003387879 |
---|---|
Provider Name | Mrs. Denise Moharsky |
First Address | Fort Collins, CO 80526-6619 |
Second Address | Fort Collins, CO 80526-6619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2018 |
Last Update Date | 18/10/2021 |