MEDICARE: MARGARET POWERS BISSONNETTE OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	OT0006786	CO
2	174400000X	Specialist

General Provider Information

NPI Number	:	1336514884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET POWERS BISSONNETTE OTR/L

Provider Business Mailing Address
First Line	:	2233 ACADEMY PL STE 200
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1666
Country	:	US
Telephone Number	:	719-301-0002
Fax Number	:	720-777-7297

Provider Business Practice Location Address
First Line	:	3131 S VAUGHN WAY STE 110
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-3501
Country	:	US
Telephone Number	:	303-755-5534
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	01/17/2025

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