Individual
MISS LACI PAIGE TECKLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4601 EAGLERIDGE PL STE 140, PUEBLO, CO 81008-4101
(719) 371-0443
(719) 253-7729
Mailing address
4601 EAGLERIDGE PL STE 140, PUEBLO, CO 81008-4101
(719) 371-0443
(719) 253-7729
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0001605
CO
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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