Individual
HILLARY KAYRIS VANDERGAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6050 ERIN PARK DR, COLORADO SPRINGS, CO 80918-3488
(719) 465-3989
Mailing address
1325 PROMONTORY CREST VW, COLORADO SPRINGS, CO 80921-3950
(719) 453-9310
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
.0005977
CO
225XP0200X
Pediatric Occupational Therapist
Primary
.0005977
CO
Other
Enumeration date
07/09/2024
Last updated
03/04/2025
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