Healthcare Provider Details

I. General information

NPI: 1770057580
Provider Name (Legal Business Name): KATIE KIEFER OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 N LOGAN ST STE B15
DENVER CO
80203-3100
US

IV. Provider business mailing address

4674 WHITE ROCK CIR APT 7
BOULDER CO
80301-6704
US

V. Phone/Fax

Practice location:
  • Phone: 720-218-0083
  • Fax:
Mailing address:
  • Phone: 970-773-0619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: