Provider Demographics
NPI:1376728436
Name:MCKELL, MOIRA C (OTD, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MOIRA
Middle Name:C
Last Name:MCKELL
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15701 E 1ST AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9037
Mailing Address - Country:US
Mailing Address - Phone:303-326-2000
Mailing Address - Fax:
Practice Address - Street 1:15701 E 1ST AVE STE 106
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9037
Practice Address - Country:US
Practice Address - Phone:303-326-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001835225X00000X
OR1003589225X00000X
WAOT60012576225X00000X
COOT.0006312225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist