Provider Demographics
NPI:1114513678
Name:WHALEN, MAUREEN T (OTR)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:T
Last Name:WHALEN
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 1:3420 MILL VISTA RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2324
Mailing Address - Country:US
Mailing Address - Phone:303-875-8415
Mailing Address - Fax:
Practice Address - Street 1:3420 MILL VISTA RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2324
Practice Address - Country:US
Practice Address - Phone:303-875-8415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2117225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist