MEDICARE: COLORADO CENTER FOR PEDIATRIC LEARNING AND DEVELOPMENT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	225XP0200X	Pediatric Occupational Therapist
3	2251P0200X	Pediatric Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477699833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO CENTER FOR PEDIATRIC LEARNING AND DEVELOPMENT

Provider Business Mailing Address
First Line	:	3700 QUEBEC ST UNIT 100-337
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-1638
Country	:	US
Telephone Number	:	303-333-4982
Fax Number	:

Provider Business Practice Location Address
First Line	:	1958 ELM ST RM 310
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-1247
Country	:	US
Telephone Number	:	303-333-4982
Fax Number	:	303-329-5894

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JULIE TOURIGNY
Credential	:	MS, OTR
Telephone Number	:	303-333-4982

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	12/16/2020

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