Provider Demographics
NPI:1326282591
Name:SCHALK, PETRA ELISABETH (LAC,OTR/L)
Entity Type:Individual
Prefix:
First Name:PETRA
Middle Name:ELISABETH
Last Name:SCHALK
Suffix:
Gender:F
Credentials:LAC,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7829 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6109
Mailing Address - Country:US
Mailing Address - Phone:303-803-0674
Mailing Address - Fax:815-550-2759
Practice Address - Street 1:7829 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6109
Practice Address - Country:US
Practice Address - Phone:303-803-0674
Practice Address - Fax:815-550-2759
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1877225X00000X
CO1494171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171100000XOther Service ProvidersAcupuncturist