Provider Demographics
NPI:1891503033
Name:KO, ERIKA ANDERSEN (CLVT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ANDERSEN
Last Name:KO
Suffix:
Gender:F
Credentials:CLVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 GALILEO DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-4474
Mailing Address - Country:US
Mailing Address - Phone:970-658-0843
Mailing Address - Fax:855-719-0408
Practice Address - Street 1:3709 GALILEO DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-4474
Practice Address - Country:US
Practice Address - Phone:970-658-0843
Practice Address - Fax:855-719-0408
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
33602255R0406X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind