Provider Demographics
NPI:1376113423
Name:HORAN, KENDALL ADELE (OTD, OTR)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:ADELE
Last Name:HORAN
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12477 VENTANA MESA CIR
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9150
Mailing Address - Country:US
Mailing Address - Phone:303-522-6830
Mailing Address - Fax:
Practice Address - Street 1:2350 LIMON DR UNIT D12
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7662
Practice Address - Country:US
Practice Address - Phone:303-522-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist