Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 569 | CO |
N | 225XH1200X | Occupational Therapist - Hand |
NPI | 1134474455 |
---|---|
Provider Name | Ms. Patricia Bothwell Kenyon |
First Address | Denver, CO 80212-1723 |
Second Address | Denver, CO 80212-1723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2012 |
Last Update Date | 24/07/2012 |