Healthcare Provider Details

I. General information

NPI: 1851303085
Provider Name (Legal Business Name): HEATHER MARIE WATT O.T.D., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6979 S HOLLY CIR STE 105
CENTENNIAL CO
80112-1065
US

IV. Provider business mailing address

6979 S HOLLY CIR STE 105
CENTENNIAL CO
80112-1577
US

V. Phone/Fax

Practice location:
  • Phone: 303-694-2295
  • Fax: 303-694-1843
Mailing address:
  • Phone: 303-694-2295
  • Fax: 303-694-1843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1046488
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1266
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: