Individual
SHELLEY ETKE TIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
2065 HILLSDALE CIR, BOULDER, CO 80305-5617
(303) 543-9232
Mailing address
2065 HILLSDALE CIR, BOULDER, CO 80305-5617
(303) 543-9232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1007123
—
225XG0600X
Gerontology Occupational Therapist
1007123
—
Other
Enumeration date
06/03/2009
Last updated
09/18/2009
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