Provider Demographics
NPI:1063138600
Name:BLAIR, CAMERON (COTA/L)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 W 87TH DR APT J
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-1663
Mailing Address - Country:US
Mailing Address - Phone:303-653-5025
Mailing Address - Fax:
Practice Address - Street 1:7820 W 87TH DR APT J
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-1663
Practice Address - Country:US
Practice Address - Phone:303-653-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0001630224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant