Healthcare Provider Details

I. General information

NPI: 1144544693
Provider Name (Legal Business Name): RIGEL A HAFNER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 PEYTON DR
FORT COLLINS CO
80525-8266
US

IV. Provider business mailing address

609 PEYTON DR
FORT COLLINS CO
80525-8266
US

V. Phone/Fax

Practice location:
  • Phone: 515-708-1460
  • Fax:
Mailing address:
  • Phone: 515-708-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2183
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: