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General NPI Number Information
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NPI Number | 1295041721
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Entity Type | Individual
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Provider Name | TANYA LAYNE TRAVIS OTR
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Gender | Female
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Dates
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Enumeration Date | 08/21/2010
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Last Update Date | 08/21/2010
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Provider Practice Location Address
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Address Line | 518 28 RD SUITE 200A
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-6556
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Country | US
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Telephone | 970-245-3565
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Fax | 970-208-9139
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Provider Business Mailing Address
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Address Line | 518 28 RD SUITE 200A
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-6556
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Country | US
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Telephone | 970-245-3565
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Fax | 970-208-9139
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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 | 887
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 887
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 887
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License Number State | CO
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