Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 0001138 | CO |
NPI | 1003232299 |
---|---|
Provider Name | Sandra Vizina |
First Address | Littleton, CO 80123-1723 |
Second Address | Littleton, CO 80123-1723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2014 |
Last Update Date | 11/03/2014 |