Healthcare Provider Details

I. General information

NPI: 1104624816
Provider Name (Legal Business Name): TWO TREES THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 S YOSEMITE CT STE 2104
CENTENNIAL CO
80112-1409
US

IV. Provider business mailing address

6860 S YOSEMITE CT STE 2104
CENTENNIAL CO
80112-1409
US

V. Phone/Fax

Practice location:
  • Phone: 720-500-2062
  • Fax:
Mailing address:
  • Phone: 720-500-2062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. FAYE KOUIMELIS
Title or Position: CEO, PSYCHOLOGIST, OT
Credential: PSYD, OTR/L
Phone: 720-500-2062