Provider Demographics
NPI:1134474455
Name:KENYON, PATRICIA BOTHWELL (OTR CHT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:BOTHWELL
Last Name:KENYON
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 1:3441 TENNYSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1723
Mailing Address - Country:US
Mailing Address - Phone:303-941-0664
Mailing Address - Fax:303-997-4832
Practice Address - Street 1:3441 TENNYSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-1723
Practice Address - Country:US
Practice Address - Phone:303-941-0664
Practice Address - Fax:303-997-4832
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO569225X00000X
225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand