Provider Demographics
NPI:1851442370
Name:DWIRE, KAREN C (OTR)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:C
Last Name:DWIRE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:C
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:7 COLOMBARD CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1251
Mailing Address - Country:US
Mailing Address - Phone:970-314-0351
Mailing Address - Fax:
Practice Address - Street 1:7 COLOMBARD CT
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-1251
Practice Address - Country:US
Practice Address - Phone:970-314-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0002549225X00000X
CA8935225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1060444OtherNBCOT CERTIFICATION
COOT.0002549OtherOT LICENSE
CA8935OtherOT LICENSE