Healthcare Provider Details

I. General information

NPI: 1740190693
Provider Name (Legal Business Name): GRAND PEAKS PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 CHIPMUNK DR
GRANBY CO
80446-5059
US

IV. Provider business mailing address

PO BOX 1417
GRANBY CO
80446-1417
US

V. Phone/Fax

Practice location:
  • Phone: 303-330-4667
  • Fax:
Mailing address:
  • Phone: 303-330-4667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LINDA MARTHINA ANDERSSON-RIGGS
Title or Position: OTR/L
Credential:
Phone: 303-330-4667