Provider Demographics
NPI:1093036238
Name:POWELL, EMMA JANE (MS OTR)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:JANE
Last Name:POWELL
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
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Mailing Address - Street 1:120 EDGEVIEW DR
Mailing Address - Street 2:APARTMENT 5201
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8077
Mailing Address - Country:US
Mailing Address - Phone:317-910-4375
Mailing Address - Fax:317-910-4375
Practice Address - Street 1:329 EXEMPLA CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3482
Practice Address - Country:US
Practice Address - Phone:317-910-4375
Practice Address - Fax:317-910-4375
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN31003405A225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation