Healthcare Provider Details

I. General information

NPI: 1306546387
Provider Name (Legal Business Name): ACCESSIBLE HOME MODIFICATIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1942 BROADWAY STE 314C
BOULDER CO
80302-5233
US

IV. Provider business mailing address

2180 S COLORADO BLVD UNIT 421
DENVER CO
80222-5026
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-5550
  • Fax:
Mailing address:
  • Phone: 678-719-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224ZE0001X
TaxonomyEnvironmental Modification Occupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEIDRE A CORBIN
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L, ECHM
Phone: 678-719-1277