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NPI Code Detail

MEDICARE: KENDALL ANN GAFFNEY COTA/L

MEDICARE: KENDALL ANN GAFFNEY COTA/L
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
1224Z00000XOccupational Therapy AssistantOTA.0001037CO

General Provider Information

NPI Number : 1780212910
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL ANN GAFFNEY COTA/L
Provider Business Mailing Address
First Line : 4250 GEMSTONE LN
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5673
Country : US
Telephone Number : 719-332-0503
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S LEMAY AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4262
Country : US
Telephone Number : 970-495-8780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 04/01/2020

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Directions to “ KENDALL ANN GAFFNEY COTA/L” Practice Location

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