Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 727 | CO |
NPI | 1003133356 |
---|---|
Provider Name | Wendy Sultzman |
First Address | Fort Collins, CO 80528-6280 |
Second Address | Fort Collins, CO 80528-6280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2010 |
Last Update Date | 27/04/2010 |