Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003404054 |
---|---|
Provider Name | Natalia Cardenas |
First Address | Fountain, CO 80817-4694 |
Second Address | Fountain, CO 80817-4694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2021 |
Last Update Date | 05/01/2021 |