Healthcare Provider Details

I. General information

NPI: 1689155012
Provider Name (Legal Business Name): AMBER YAEGER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER YAEGER OTR/L

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7935 E PRENTICE AVE STE 104
GREENWOOD VILLAGE CO
80111-2711
US

IV. Provider business mailing address

7935 E PRENTICE AVE STE 104
GREENWOOD VILLAGE CO
80111-2711
US

V. Phone/Fax

Practice location:
  • Phone: 303-756-0280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0005598
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: