Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0002539 | CO |
NPI | 1083780738 |
---|---|
Provider Name | Ms. Betty Alice Augustat |
First Address | Littleton, CO 80127-4855 |
Second Address | Westminster, CO 80031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 13/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9105000665 | HTC (01) | CO |
AA434639 | OTR (01) | CO |