Provider Demographics
NPI:1760744353
Name:OBERNDORF, AARON ROBERT (MS, OTR/R)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:ROBERT
Last Name:OBERNDORF
Suffix:
Gender:M
Credentials:MS, OTR/R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 KILLARNEY CT
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:CO
Mailing Address - Zip Code:80535-9337
Mailing Address - Country:US
Mailing Address - Phone:970-420-5143
Mailing Address - Fax:
Practice Address - Street 1:3416 KILLARNEY CT
Practice Address - Street 2:
Practice Address - City:LAPORTE
Practice Address - State:CO
Practice Address - Zip Code:80535-9337
Practice Address - Country:US
Practice Address - Phone:970-420-5143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT-1538225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist