Organization
LIBBEY OCCUPATIONAL THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NISA RUSSELL LIBBEY B.S. OTR/L (OCCUPATIONAL THERAPIST, OWNER)
(720) 308-2565
Entity
Organization
Contact information
Practice address
100 WEST ARAPAHOE LN, SUITE 12, BOULDER, CO 80302
(720) 308-2565
Mailing address
345 VERNIER AVE, LAFAYETTE, CO 80026-3128
(720) 308-2565
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0004073
CO
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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