Provider Demographics
NPI:1275015000
Name:GRAHAM, NANCY SECCOMBE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SECCOMBE
Last Name:GRAHAM
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 1:6093 S QUEBEC ST STE 203
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4544
Mailing Address - Country:US
Mailing Address - Phone:720-260-3455
Mailing Address - Fax:
Practice Address - Street 1:6093 SOUTH QUEBEC STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:720-260-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2377225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics