Individual
MS. NISA RUSSELL LIBBEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
345 VERNIER AVE, LAFAYETTE, CO 80026-3128
(720) 308-2565
Mailing address
345 VERNIER AVE, LAFAYETTE, CO 80026-3128
(720) 308-2565
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0004073
CO
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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