Provider Demographics
NPI:1285893073
Name:BOUTIN, DEBRA MARIE (COTA)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MARIE
Last Name:BOUTIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2309
Mailing Address - Country:US
Mailing Address - Phone:303-537-1715
Mailing Address - Fax:
Practice Address - Street 1:10201 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-4301
Practice Address - Country:US
Practice Address - Phone:303-364-3364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant