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Individual

MATTHIAS HALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
451 BOARDWALK DR, APT 1118, FORT COLLINS, CO 80525-3220
(614) 309-9685
Mailing address
451 BOARDWALK DR, APT 1118, FORT COLLINS, CO 80525-3220
(614) 309-9685

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211930
TX
224Z00000X
Occupational Therapy Assistant
OTA.04763
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
288650
NBCOT
MD
Enumeration date
12/06/2012
Last updated
12/06/2012
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