Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0001132 | CO |
NPI | 1407390677 |
---|---|
Provider Name | Renee Sickler |
First Address | Highlands Ranch, CO 80129-5670 |
Second Address | Highlands Ranch, CO 80129-5670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2016 |
Last Update Date | 07/12/2016 |