Provider Demographics
NPI:1154746907
Name:MULDOON, TIMOTHY NEIL (OT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:NEIL
Last Name:MULDOON
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:STE 500
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2771
Mailing Address - Country:US
Mailing Address - Phone:303-774-7078
Mailing Address - Fax:303-777-4563
Practice Address - Street 1:8585 S EASTERN AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2818
Practice Address - Country:US
Practice Address - Phone:702-798-8585
Practice Address - Fax:702-341-0109
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-2205225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist