Individual
ALLYSON JEANETTE MICHAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
951 FLORIDA ST, CANON CITY, CO 81212-8569
(719) 276-0724
Mailing address
951 FLORIDA ST, CANON CITY, CO 81212-8569
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1048123
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1048123
MEDICARE
CO
Enumeration date
09/14/2012
Last updated
09/14/2012
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