Healthcare Provider Details

I. General information

NPI: 1538960232
Provider Name (Legal Business Name): ELLEN KYRIAKOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 S COLORADO BLVD STE 150
DENVER CO
80246-1904
US

IV. Provider business mailing address

2821 S PARKER RD STE 615
AURORA CO
80014-2711
US

V. Phone/Fax

Practice location:
  • Phone: 720-542-8737
  • Fax: 720-242-8085
Mailing address:
  • Phone: 720-542-8737
  • Fax: 720-242-8085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0008756
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: