Healthcare Provider Details

I. General information

NPI: 1588801328
Provider Name (Legal Business Name): KARIN PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARIN OCKULY

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 QUEBEC ST UNIT 100-337
DENVER CO
80207-1638
US

IV. Provider business mailing address

2854 S GOLDEN WAY
DENVER CO
80227-3848
US

V. Phone/Fax

Practice location:
  • Phone: 303-333-4982
  • Fax:
Mailing address:
  • Phone: 303-570-8165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0003566
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: