Provider Demographics
NPI:1033770870
Name:KILLPACK, STEPHANIE ALEEN (OTR)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ALEEN
Last Name:KILLPACK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210A ROUTT CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1384
Mailing Address - Country:US
Mailing Address - Phone:801-380-3261
Mailing Address - Fax:
Practice Address - Street 1:11154 HURON ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-2329
Practice Address - Country:US
Practice Address - Phone:720-381-0624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics