Healthcare Provider Details

I. General information

NPI: 1730427253
Provider Name (Legal Business Name): DIONE WEATHERSBY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2013
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 E 28TH AVE
DENVER CO
80238-2627
US

IV. Provider business mailing address

1860 N LINCOLN ST FL 11
DENVER CO
80203-2996
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-0727
  • Fax:
Mailing address:
  • Phone: 720-423-4101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1058920
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: