Provider Demographics
NPI:1477124741
Name:STINTON, KELLI (OTD)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:STINTON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 W 144TH AVE UNIT 200
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9483
Mailing Address - Country:US
Mailing Address - Phone:303-284-6569
Mailing Address - Fax:
Practice Address - Street 1:575 TANTRA DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6195
Practice Address - Country:US
Practice Address - Phone:423-534-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006932225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist