Provider Demographics
NPI:1033568852
Name:HAZEN, KATHERINE YVONNE (PT)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:YVONNE
Last Name:HAZEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9721 BURNTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4715
Mailing Address - Country:US
Mailing Address - Phone:720-841-2070
Mailing Address - Fax:
Practice Address - Street 1:HIGHLINE PLACE
Practice Address - Street 2:6767 BROADWAY
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-647-5780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0016290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist