Provider Demographics
NPI:1275821613
Name:GAITOR, MAUREEN (OTL)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:GAITOR
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 SPRING CANYON HTS
Mailing Address - Street 2:APARTMENT 202
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-9401
Mailing Address - Country:US
Mailing Address - Phone:518-441-8524
Mailing Address - Fax:
Practice Address - Street 1:4635 SPRING CANYON HTS
Practice Address - Street 2:APARTMENT 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-9401
Practice Address - Country:US
Practice Address - Phone:518-441-8524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2090225X00000X
MA10250225X00000X
VT072.0077695225X00000X
CO3185225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist