=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235420159
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARINA LANGENBACH OTD, OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2011
-----------------------------------------------------
Last Update Date | 10/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8805 W 14TH AVE STE 320
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80215-4850
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-213-0603
-----------------------------------------------------
Fax | 720-316-5962
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2329 S FRANKLIN ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-5105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-213-0603
-----------------------------------------------------
Fax | 719-213-0603
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XN1300X
-----------------------------------------------------
Taxonomy Name | Neurorehabilitation Occupational Therapist
-----------------------------------------------------
License Number | OT.0006432
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------