Individual
LUCILLE R GROOTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1321 S PRAIRIE AVE, PUEBLO, CO 81005-2307, PUEBLO, CO 81008-2176
(719) 582-8736
Mailing address
230 GRIFFIN AVE, CANON CITY, CO 81212-4138
(719) 597-0822
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-262100
CO
225X00000X
Occupational Therapist
Primary
OT.0009217
CO
Other
Enumeration date
04/11/2023
Last updated
02/04/2026
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