Individual
EVA KATHLEEN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
5775 N UNION BLVD, COLORADO SPRINGS, CO 80918-1744
(719) 434-7044
(719) 375-1276
Mailing address
111 CRYSTAL PARK RD, UNIT 1, MANITOU SPRINGS, CO 80829-2652
(512) 788-3762
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
114685
TX
225X00000X
Occupational Therapist
Primary
OT.0003655
CO
Other
Enumeration date
06/08/2012
Last updated
09/14/2016
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