Shelley Etke Tidd
Occupational Therapist Occupational Therapist - Gerontology
2065 Hillsdale Cir
Boulder
, Colorado 80305-5617
Shelley Etke Tidd
Occupational Therapist Occupational Therapist - Gerontology
2065 Hillsdale Cir
Boulder
, Colorado 80305-5617
(303) 543-9232
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About
Features
Specialties
- Occupational Therapist
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Shelley Etke Tidd
- 2065 Hillsdale Cir
- Boulder, CO
- Zip : 80305-5617
- Phone : (303) 543-9232
Second Address
- Shelley Etke Tidd
- 2065 Hillsdale Cir
- Boulder, CO
- Zip : 80305-5617
- Phone : (303) 543-9232
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 1007123 | |
| N | 225XG0600X | Occupational Therapist - Gerontology | 1007123 |
National Provider Identifier
| NPI | 1326274317 |
|---|---|
| Provider Name | Shelley Etke Tidd |
| First Address | Boulder, CO 80305-5617 |
| Second Address | Boulder, CO 80305-5617 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/06/2009 |
| Last Update Date | 18/09/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.