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Individual

BENNETT T COUSLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
6270 W 38TH AVE, WHEAT RIDGE, CO 80033-5056
(303) 421-6520
Mailing address
2950 OTIS CT, WHEAT RIDGE, CO 80214-8047
(720) 435-4044

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1043282
CO

Other

Enumeration date
07/26/2012
Last updated
07/26/2012
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