Provider Demographics
NPI:1346483054
Name:GILBERT, DIANE (OTR)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:GILBERT
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 1:12660 N FOREST CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8277
Mailing Address - Country:US
Mailing Address - Phone:303-841-0275
Mailing Address - Fax:303-805-4056
Practice Address - Street 1:12660 N FOREST CANYON DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8277
Practice Address - Country:US
Practice Address - Phone:303-841-0275
Practice Address - Fax:303-805-4056
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225XPOO19X225X00000X
COOT-1547225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist