Healthcare Provider Details

I. General information

NPI: 1619726536
Provider Name (Legal Business Name): RACHEL BARHAM CARLSON OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 9TH AVE
GREELEY CO
80631-4039
US

IV. Provider business mailing address

4419 SHIVAREE ST
TIMNATH CO
80547-4532
US

V. Phone/Fax

Practice location:
  • Phone: 970-348-6000
  • Fax:
Mailing address:
  • Phone: 772-834-7525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberMSOT.00000023
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: