Provider Demographics
NPI:1316137649
Name:THATCH-WOODY, GLORIA LEE (OTR)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:LEE
Last Name:THATCH-WOODY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10792 ROAD 41.2
Mailing Address - Street 2:
Mailing Address - City:MANCOS
Mailing Address - State:CO
Mailing Address - Zip Code:81328-7801
Mailing Address - Country:US
Mailing Address - Phone:970-533-9180
Mailing Address - Fax:970-533-9180
Practice Address - Street 1:10792 ROAD 41.2
Practice Address - Street 2:
Practice Address - City:MANCOS
Practice Address - State:CO
Practice Address - Zip Code:81328-7801
Practice Address - Country:US
Practice Address - Phone:970-533-9180
Practice Address - Fax:970-533-9180
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist