Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | AA274134 |
NPI | 1023165073 |
---|---|
Provider Name | Ms. Kathleen Kyffin Schleifer |
First Address | Pueblo West, CO 81007-3105 |
Second Address | Pueblo West, CO 81007-3105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12283240 | (05) | CO |