Provider Demographics
NPI:1003387879
Name:MOHARSKY, DENISE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:MOHARSKY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 W STUART ST APT 5
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6619
Mailing Address - Country:US
Mailing Address - Phone:714-274-4643
Mailing Address - Fax:
Practice Address - Street 1:2955 W STUART ST APT 5
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6619
Practice Address - Country:US
Practice Address - Phone:714-274-4643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005538225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist