Provider Demographics
NPI:1639341704
Name:KOCA, JODY MARIE RIVERA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:MARIE RIVERA
Last Name:KOCA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:JODY
Other - Middle Name:MARIE
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1829 DENVER WEST DR # 27
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3120
Mailing Address - Country:US
Mailing Address - Phone:303-982-6500
Mailing Address - Fax:
Practice Address - Street 1:1829 DENVER WEST DR # 27
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3120
Practice Address - Country:US
Practice Address - Phone:303-982-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-29
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1010497225X00000X
COOT.0001605225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist