Provider Demographics
NPI:1063719979
Name:INNOVATIVE OCCUPATIONAL THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:INNOVATIVE OCCUPATIONAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTD, OTR/L
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAN'NA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-484-5705
Mailing Address - Street 1:14201 E 4TH AVE
Mailing Address - Street 2:STE 265
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8748
Mailing Address - Country:US
Mailing Address - Phone:720-484-5705
Mailing Address - Fax:303-200-7069
Practice Address - Street 1:14201 E 4TH AVE
Practice Address - Street 2:STE 265
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8748
Practice Address - Country:US
Practice Address - Phone:720-484-5705
Practice Address - Fax:303-200-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-12
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty