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General NPI Number Information
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NPI Number | 1982244422
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Entity Type | Individual
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Provider Name | LAURYN NICOLE BERGLUND OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 7200 E QUINCY AVE
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City | DENVER
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State | CO
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Zip | 80237-2255
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Country | US
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Telephone | 303-221-9611
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N 46TH ST APT 1409
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City | OMAHA
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State | NE
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Zip | 68132-3264
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Country | US
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Telephone | 402-536-9054
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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 | 6290
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License Number State | CO
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