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NPI 1972088136

NPI 1972088136 : ELISE CHEVALIER OTR/L : ENGLEWOOD, CO

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General NPI Number Information
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    NPI Number           |    1972088136
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    Entity Type          |    Individual 
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    Provider Name        |    ELISE CHEVALIER OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/03/2018
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    Last Update Date     |    10/10/2024
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Provider Practice Location Address
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    Address Line         |    175 INVERNESS DR W STE 100 
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    City                 |    ENGLEWOOD
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    State                |    CO
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    Zip                  |    80112-5066
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    Country              |    US
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    Telephone            |    303-694-3333
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    Fax                  |    303-694-9666
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Provider Business Mailing Address
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    Address Line         |    2695 ROCKY MOUNTAIN AVE STE 150 
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    City                 |    LOVELAND
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    State                |    CO
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    Zip                  |    80538-9071
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    Country              |    US
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    Telephone            |    970-624-1103
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    OT-1972
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    License Number State |    ID
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Taxonomy #2
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    OT.0008177
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    License Number State |    CO
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