MEDICARE: ANGELA L.S. GRAF

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	225X00000X	Occupational Therapist	4349-26	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4349-26	OTHER	WI	OT

General Provider Information

NPI Number	:	1588681597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA L.S. GRAF

Provider Business Mailing Address
First Line	:	7770 E ILIFF AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-7010
Country	:	US
Telephone Number	:	720-289-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	7770 E ILIFF AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-7010
Country	:	US
Telephone Number	:	303-333-8360
Fax Number	:

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	12/21/2020

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