Provider Demographics
NPI:1093866824
Name:HALL, EMILY JEAN (OTR, LAC)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:JEAN
Last Name:HALL
Suffix:
Gender:F
Credentials:OTR, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7939 STOLL PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3291
Mailing Address - Country:US
Mailing Address - Phone:720-935-0690
Mailing Address - Fax:
Practice Address - Street 1:3401 QUEBEC ST STE 6900
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2399
Practice Address - Country:US
Practice Address - Phone:720-935-0690
Practice Address - Fax:720-815-2096
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002302171100000X
IL056005579225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171100000XOther Service ProvidersAcupuncturist