Provider Demographics
NPI:1528952041
Name:LARSEN, EMILY (OTR)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LARSEN
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 1:3654 G 7/10 RD
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-8727
Mailing Address - Country:US
Mailing Address - Phone:970-549-7945
Mailing Address - Fax:
Practice Address - Street 1:3654 G 7/10 RD
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526-8727
Practice Address - Country:US
Practice Address - Phone:970-549-7945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-07
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0007714225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist