Individual
MISS THERESA MARIE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5820 FLINTRIDGE DRIVE, COLORADO SPRINGS, CO 80918
(719) 599-7328
(719) 264-0227
Mailing address
5820 FLINTRIDGE DR, COLORADO SPRINGS, CO 80918-1883
(719) 599-7328
(719) 264-0227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1699
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699
STATE OF COLORADO LICENSURE
CO
Enumeration date
04/06/2009
Last updated
04/10/2009
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