Provider Demographics
NPI:1033503842
Name:CELMER, KATHLEEN (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:CELMER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10767 COOK ST
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4496
Mailing Address - Country:US
Mailing Address - Phone:303-929-0489
Mailing Address - Fax:
Practice Address - Street 1:10767 COOK ST
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-4496
Practice Address - Country:US
Practice Address - Phone:303-929-0489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA0000395225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
COOTA 0000395OtherDORA, STATE OF COLORADO OTA LICENSE
1031049OtherNBCOT