Healthcare Provider Details

I. General information

NPI: 1619380367
Provider Name (Legal Business Name): MARCIA HAWLEY BAKEMEYER O.T.R.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42125 LAS COLINAS DR
ELIZABETH CO
80107-9115
US

IV. Provider business mailing address

42125 LAS COLINAS DRIVE
ELIZABETH CO
80107
US

V. Phone/Fax

Practice location:
  • Phone: 303-243-1713
  • Fax:
Mailing address:
  • Phone: 303-243-1713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0002055
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License NumberOT.0002055
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOT.0002055
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT.0002055
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT.0002055
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: