Provider Demographics
NPI:1639367022
Name:DAVIS, RHONDA CHRISTINE (COTA)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:CHRISTINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34001 COUNTY ROAD X
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:CO
Mailing Address - Zip Code:81047-9626
Mailing Address - Country:US
Mailing Address - Phone:719-688-3719
Mailing Address - Fax:
Practice Address - Street 1:320 8TH STREET
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:CO
Practice Address - Zip Code:81047
Practice Address - Country:US
Practice Address - Phone:719-537-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1021304224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant