Healthcare Provider Details

I. General information

NPI: 1801457619
Provider Name (Legal Business Name): DARLENE BYERS COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2019
Last Update Date: 06/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 S GARFIELD AVE
LOVELAND CO
80537-7377
US

IV. Provider business mailing address

6671 14TH ST
FREDERICK CO
80530-7001
US

V. Phone/Fax

Practice location:
  • Phone: 970-669-3100
  • Fax:
Mailing address:
  • Phone: 303-775-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: