Individual
KAYLEIGH R GREENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4601 EAGLERIDGE PL, PUEBLO, CO 81008-4100
(719) 253-7727
(719) 253-7729
Mailing address
4601 EAGLERIDGE PL, PUEBLO, CO 81008-4100
(719) 253-7727
(719) 253-7727
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0001598
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29750521
—
CO
Enumeration date
07/21/2022
Last updated
07/21/2022
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