Provider Demographics
NPI:1629746516
Name:QUINTANILLA, KATE MELISSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MELISSA
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 S DUNKIRK WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3740
Mailing Address - Country:US
Mailing Address - Phone:818-216-0241
Mailing Address - Fax:
Practice Address - Street 1:8301 E PRENTICE AVE STE 207
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2905
Practice Address - Country:US
Practice Address - Phone:303-322-8300
Practice Address - Fax:303-320-3823
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.000630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist