Provider Demographics
NPI:1932940327
Name:JAVIER, GABRIELLE LEILANI (OTR/L)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:LEILANI
Last Name:JAVIER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W HORSETOOTH RD APT 4A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5962
Mailing Address - Country:US
Mailing Address - Phone:925-323-1381
Mailing Address - Fax:
Practice Address - Street 1:4650 ROYAL VISTA CIR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80528-9321
Practice Address - Country:US
Practice Address - Phone:970-305-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0008461225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist