Provider Demographics
NPI:1639556459
Name:LEVINE, FRAN ALISON (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:FRAN
Middle Name:ALISON
Last Name:LEVINE
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 1:913 ASHFORD LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526
Mailing Address - Country:US
Mailing Address - Phone:970-310-6961
Mailing Address - Fax:
Practice Address - Street 1:913 ASHFORD LN
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-3924
Practice Address - Country:US
Practice Address - Phone:970-310-6961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000685225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
COOT.0000685OtherCO DEPARTMENT OF REGULATORY AGENCIES OCCUPATIONAL THERAPY LICENSE
999262OtherNBCOT