Provider Demographics
NPI:1497181564
Name:WENGROVIUS, CHRISTINE LYNNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNNE
Last Name:WENGROVIUS
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 1:3712 W 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2642
Mailing Address - Country:US
Mailing Address - Phone:303-466-8286
Mailing Address - Fax:
Practice Address - Street 1:1950 S DAYTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-3452
Practice Address - Country:US
Practice Address - Phone:303-745-3664
Practice Address - Fax:303-755-0098
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT-972225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist