Provider Demographics
NPI:1669831251
Name:ESPINO-KENNEDY, KATIE MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:ESPINO-KENNEDY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:ESPINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:3580 E 100TH CT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-3548
Mailing Address - Country:US
Mailing Address - Phone:720-244-3707
Mailing Address - Fax:
Practice Address - Street 1:8301 E PRENTICE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2903
Practice Address - Country:US
Practice Address - Phone:720-244-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0000726224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant