Provider Demographics
NPI:1003964495
Name:GOOD-DECURNOU, LUANN (OTR, CHT)
Entity Type:Individual
Prefix:MS
First Name:LUANN
Middle Name:
Last Name:GOOD-DECURNOU
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 GORE RANGE WAY
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-2076
Mailing Address - Country:US
Mailing Address - Phone:303-514-1815
Mailing Address - Fax:
Practice Address - Street 1:500 W 144TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9328
Practice Address - Country:US
Practice Address - Phone:303-665-2603
Practice Address - Fax:303-665-2605
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001797225XH1200X
COOT.0001431225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand