Provider Demographics
NPI:1124362405
Name:MATTHIAS, WHITNEY DIANE (MOT, OTR)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:DIANE
Last Name:MATTHIAS
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:DIANE
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:975 PLATTE RIVER BLVD
Mailing Address - Street 2:UNIT O
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:975 PLATTE RIVER BLVD
Practice Address - Street 2:UNIT O
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4349
Practice Address - Country:US
Practice Address - Phone:303-659-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003559225X00000X
303063225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist