Provider Demographics
NPI:1164766366
Name:COHN, MARLENE KATHY
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:KATHY
Last Name:COHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARLENE
Other - Middle Name:
Other - Last Name:TILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:3616 S HIBISCUS WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1041
Mailing Address - Country:US
Mailing Address - Phone:303-766-4170
Mailing Address - Fax:
Practice Address - Street 1:3616 S HIBISCUS WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1041
Practice Address - Country:US
Practice Address - Phone:303-766-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2543225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist