Organization
SQUARE PEG THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY HOLGATE MS, OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(303) 589-7458
Entity
Organization
Contact information
Practice address
19501 E MAINSTREET STE 200, PARKER, CO 80138-7408
(303) 589-7458
Mailing address
19501 E MAINSTREET STE 200, PARKER, CO 80138-7408
(303) 589-7458
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/02/2020
Last updated
09/10/2021
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