Healthcare Provider Details

I. General information

NPI: 1649061540
Provider Name (Legal Business Name): MADISON DOUGAREE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 CAMPUS DR STE 100
COLORADO SPRINGS CO
80920-3107
US

IV. Provider business mailing address

996 BRONSON HTS APT 210
COLORADO SPRINGS CO
80907-6582
US

V. Phone/Fax

Practice location:
  • Phone: 410-772-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT.0009264
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: