Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT.0002055 | CO |
N | 225XE0001X | Environmental Modification | OT.0002055 | CO |
N | 225XF0002X | Feeding, Eating & Swallowing | OT.0002055 | CO |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT.0002055 | CO |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT.0002055 | CO |
NPI | 1619380367 |
---|---|
Provider Name | Ms. Marcia Hawley Bakemeyer |
First Address | Elizabeth, CO 80107 |
Second Address | Elizabeth, CO 80107-9115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 10/06/2014 |