Provider Demographics
NPI:1417723628
Name:LE, DEANNA (OT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S MONACO PKWY APT 608
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1122
Mailing Address - Country:US
Mailing Address - Phone:970-988-1533
Mailing Address - Fax:
Practice Address - Street 1:230 S MONACO PKWY APT 608
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1122
Practice Address - Country:US
Practice Address - Phone:970-988-1533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005662225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist