Provider Demographics
NPI:1164167532
Name:SMITH, BRITNEY DIANNE (COTA/L)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:DIANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:BRITNEY
Other - Middle Name:DIANNE
Other - Last Name:NUNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12045 RIO SECCO RD
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831
Mailing Address - Country:US
Mailing Address - Phone:719-330-7480
Mailing Address - Fax:
Practice Address - Street 1:12045 RIO SECCO RD
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831
Practice Address - Country:US
Practice Address - Phone:719-330-7480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0000904224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant