Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT.0007152 | CO |
NPI | 1063173359 |
---|---|
Provider Name | Talley Halvorson |
First Address | Platteville, CO 80651-7582 |
Second Address | Grand Junction, CO 81505-6401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2022 |
Last Update Date | 07/01/2022 |