Provider Demographics
NPI:1689101974
Name:COHEN, DEBORAH ANN (OTR)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:COHEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 383
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-0383
Mailing Address - Country:US
Mailing Address - Phone:970-470-9676
Mailing Address - Fax:
Practice Address - Street 1:6767 S SPRUCE ST STE 102
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1284
Practice Address - Country:US
Practice Address - Phone:970-470-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004672225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty