Provider Demographics
NPI:1699189811
Name:ZAMORA-HARRIS, MARIA MONICA (PTA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MONICA
Last Name:ZAMORA-HARRIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:ZAMORA-HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:2955 GLENWOOD DR
Mailing Address - Street 2:APT. 319
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1317
Mailing Address - Country:US
Mailing Address - Phone:410-802-0907
Mailing Address - Fax:
Practice Address - Street 1:6060 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5721
Practice Address - Country:US
Practice Address - Phone:303-759-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013314225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant