| NPI | 1083598122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK MARION WAHLERT Occupational Therapist 719-821-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| 225XF0002X Occupational Therapist Feeding, Eating & Swallowing | |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-03 |