Provider Demographics
NPI:1669038949
Name:ECK, KRISTIN DENISE
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DENISE
Last Name:ECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 S DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5725
Mailing Address - Country:US
Mailing Address - Phone:720-635-8032
Mailing Address - Fax:
Practice Address - Street 1:11479 PINE DR OFC 1
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7308
Practice Address - Country:US
Practice Address - Phone:303-840-6374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT0002300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist