Provider Demographics
NPI:1427276781
Name:HART, BETSY JANE (MS, OTR)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:JANE
Last Name:HART
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S WADSWORTH BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3246
Mailing Address - Country:US
Mailing Address - Phone:720-296-5522
Mailing Address - Fax:720-962-4466
Practice Address - Street 1:2525 S WADSWORTH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3246
Practice Address - Country:US
Practice Address - Phone:720-962-4555
Practice Address - Fax:720-962-4466
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0001102225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11824832Medicaid