Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OTA0000395 | CO |
NPI | 1033503842 |
---|---|
Provider Name | Ms. Kathleen Celmer |
First Address | Northglenn, CO 80233-4496 |
Second Address | Northglenn, CO 80233-4496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2015 |
Last Update Date | 19/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1031049 | NBCOT (01) | |
OTA 0000395 | DORA, STATE OF COLORADO OTA LICENSE (01) | CO |