Provider Demographics
NPI:1619198462
Name:OSGOOD, MICHELLE A (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 CARBON PL
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-6169
Mailing Address - Country:US
Mailing Address - Phone:303-938-1141
Mailing Address - Fax:303-938-1311
Practice Address - Street 1:3020 CARBON PL
Practice Address - Street 2:SUITE 330
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-6169
Practice Address - Country:US
Practice Address - Phone:303-938-1141
Practice Address - Fax:303-938-1311
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
COS75461Medicare UPIN
CO24433Medicare PIN