Provider Demographics
NPI:1154920262
Name:STRATTON, CARISSA LYNN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:LYNN
Last Name:STRATTON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10184 E I25 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-5445
Mailing Address - Country:US
Mailing Address - Phone:720-378-6670
Mailing Address - Fax:
Practice Address - Street 1:5689 MCWHINNEY BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8826
Practice Address - Country:US
Practice Address - Phone:970-292-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006497225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist