| NPI | 1306397229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER NOELLE VAUGHN Owner 970-222-4620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CO OT.0004164) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO OT.0004164) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2021-06-15 |