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General NPI Number Information
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NPI Number | 1396297412
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Entity Type | Organization
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Legal Business Name | LOTUS OCCUPATIONAL THERAPY AND YOGA
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 2800 KALMIA AVE APT B305
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City | BOULDER
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State | CO
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Zip | 80301-1569
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Country | US
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Telephone | 708-227-7862
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 KALMIA AVE APT B305
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City | BOULDER
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State | CO
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Zip | 80301-1569
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Country | US
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Telephone | 708-227-7862
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | ANNA STOECKLIN
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Credential |
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Telephone | 708-227-7862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT.0004743
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License Number State | CO
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