Healthcare Provider Details

I. General information

NPI: 1053758151
Provider Name (Legal Business Name): OWL TREE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 E 41ST CT
LOVELAND CO
80538-4815
US

IV. Provider business mailing address

365 E 41ST CT
LOVELAND CO
80538-4815
US

V. Phone/Fax

Practice location:
  • Phone: 970-231-0744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CRAIG TURLEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 970-231-0744