Provider Demographics
NPI:1295041721
Name:TRAVIS, TANYA LAYNE (OTR)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:LAYNE
Last Name:TRAVIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:518 28 RD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6556
Mailing Address - Country:US
Mailing Address - Phone:970-245-3565
Mailing Address - Fax:970-208-9139
Practice Address - Street 1:518 28 RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6556
Practice Address - Country:US
Practice Address - Phone:970-245-3565
Practice Address - Fax:970-208-9139
Is Sole Proprietor?:No
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO887225X00000X, 225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics