Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3246 | CO |
N | 225X00000X | Occupational Therapist | 9507 | MA |
N | 225XG0600X | Occupational Therapist - Gerontology | 46TR00476700 | NJ |
NPI | 1720248479 |
---|---|
Provider Name | Mrs. Leah Difalco |
First Address | Lakewood, CO 80227-5006 |
Second Address | Lakewood, CO 80227-5006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 25/02/2014 |