Provider Demographics
NPI:1851986673
Name:MANNISIO, ANNA ELIZABETH (OT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ELIZABETH
Last Name:MANNISIO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:MANNISIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANNA SUMPMANN, OT
Mailing Address - Street 1:7030 W YALE AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5737
Mailing Address - Country:US
Mailing Address - Phone:720-460-6640
Mailing Address - Fax:
Practice Address - Street 1:333 W HAMPDEN AVE STE 500
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2335
Practice Address - Country:US
Practice Address - Phone:303-781-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO.00003659225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty