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General NPI Number Information
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NPI Number | 1063833259
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Entity Type | Organization
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Legal Business Name | PEEK-A-BOO PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 12/15/2013
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Last Update Date | 11/25/2015
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Provider Practice Location Address
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Address Line | 172 S LOWELL BLVD
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City | DENVER
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State | CO
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Zip | 80219-1934
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Country | US
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Telephone | 303-885-9848
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Fax | 720-302-0459
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Provider Business Mailing Address
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Address Line | 172 S LOWELL BLVD
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City | DENVER
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State | CO
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Zip | 80219-1934
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Country | US
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Telephone | 303-885-9848
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Fax | 720-302-0459
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | AMANDA LYNN SHIMKUS
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Credential | MA, OTR/L
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Telephone | 303-885-9848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | OT0003580
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License Number State | CO
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