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Individual

VIRGINIA NIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1259 S QUAIL ST, LAKEWOOD, CO 80232
(720) 436-8441
Mailing address
1259 S QUAIL ST, LAKEWOOD, CO 80232-4933
(720) 436-8441

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
354751
OR
225X00000X
Occupational Therapist
3833
NM
225X00000X
Occupational Therapist
Primary
OT-0004591
CO
225X00000X
Occupational Therapist
OT-1262
WY
225X00000X
Occupational Therapist
OT18886
CA

Other

Enumeration date
05/04/2017
Last updated
08/16/2018
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