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General NPI Number Information
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NPI Number | 1184268039
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Entity Type | Individual
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Provider Name | CARLY JOY MCCANCE MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 9000 E NICHOLS AVE STE 100
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City | CENTENNIAL
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State | CO
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Zip | 80112-3429
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Country | US
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Telephone | 720-706-3396
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Fax |
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Provider Business Mailing Address
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Address Line | 9763 LANE ST
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City | THORNTON
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State | CO
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Zip | 80260-8025
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Country | US
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Telephone | 856-745-1064
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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.0005925
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT.0005925
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License Number State | CO
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