Healthcare Provider Details

I. General information

NPI: 1710841390
Provider Name (Legal Business Name): KATHERINE TAYLOR HAYNES OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 HAHNS PEAK DR
LOVELAND CO
80538-8852
US

IV. Provider business mailing address

2707 CLAREMONT DR
FORT COLLINS CO
80526-2280
US

V. Phone/Fax

Practice location:
  • Phone: 970-836-2566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0009086
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: