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Individual

MRS. MARLENE LESLIE WALTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
1916 SUNSET CIR, EVERGREEN, CO 80439-8970
(303) 670-1510
(303) 893-8313
Mailing address
1916 SUNSET CIR, EVERGREEN, CO 80439-8970
(303) 670-1510
(303) 893-8313

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1552
CO

Other

Enumeration date
11/12/2009
Last updated
11/12/2009
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