Individual
HOLLY CATHERINE GRACE TAVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1610 DRY CREEK DR, LONGMONT, CO 80503-6405
(720) 494-4750
(970) 493-1794
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
(970) 493-1794
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
007709
AZ
225X00000X
Occupational Therapist
Primary
OT.0006677
CO
Other
Enumeration date
02/25/2019
Last updated
06/30/2021
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