Provider Demographics
NPI:1083780738
Name:AUGUSTAT, BETTY ALICE (OTR CHT)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:ALICE
Last Name:AUGUSTAT
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 1:6612 S WARD ST
Mailing Address - Street 2:#100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4855
Mailing Address - Country:US
Mailing Address - Phone:303-650-6616
Mailing Address - Fax:303-650-0718
Practice Address - Street 1:5005 W 81ST PL
Practice Address - Street 2:#100
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031
Practice Address - Country:US
Practice Address - Phone:303-650-6616
Practice Address - Fax:303-650-0718
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002539225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAA434639OtherOTR
CO9105000665OtherHTC