Individual
ELLEN HIESTAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4730 TABLE MESA DR STE K100, BOULDER, CO 80305-5591
(303) 954-8423
Mailing address
2857 SHADOW CREEK DR, BOULDER, CO 80303-1738
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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