MEDICARE: NOCO PEDIATRIC OT, LLC

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	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational 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	:	1841873981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOCO PEDIATRIC OT, LLC

Provider Business Mailing Address
First Line	:	4650 ROYAL VISTA CIR STE 100
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80528-9321
Country	:	US
Telephone Number	:	970-305-5070
Fax Number	:	970-541-0357

Provider Business Practice Location Address
First Line	:	5020 E COUNTY ROAD 40
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-9009
Country	:	US
Telephone Number	:	970-305-5070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TANEAL BEHM
Credential	:
Telephone Number	:	970-305-5070

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	12/11/2025

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