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General NPI Number Information
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NPI Number | 1114234036
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Entity Type | Individual
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Provider Name | EMILY MEADOWS PAK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 9039 E PANORAMA CIR UNIT 205
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City | CENTENNIAL
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State | CO
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Zip | 80112-3567
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Country | US
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Telephone | 205-249-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 S ALTON WAY
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City | CENTENNIAL
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State | CO
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Zip | 80112-2201
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Country | US
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Telephone | 720-488-9040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-2779
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License Number State | CO
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