MEDICARE: MISS CATHY JUNE WINNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	999286	CO

General Provider Information

NPI Number	:	1639321706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CATHY JUNE WINNER

Provider Business Mailing Address
First Line	:	9505 W COAL MINE AVE APT B
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-4068
Country	:	US
Telephone Number	:	720-838-0540
Fax Number	:

Provider Business Practice Location Address
First Line	:	9505 W COAL MINE AVE APT B
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-4068
Country	:	US
Telephone Number	:	720-838-0540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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