Provider Demographics
NPI:1871829556
Name:REILING, KRISTA MARIE (COTA/RD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MARIE
Last Name:REILING
Suffix:
Gender:F
Credentials:COTA/RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9160 W 64TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3111
Mailing Address - Country:US
Mailing Address - Phone:303-432-2362
Mailing Address - Fax:303-431-0243
Practice Address - Street 1:9160 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3111
Practice Address - Country:US
Practice Address - Phone:303-432-2362
Practice Address - Fax:303-431-0243
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1076194224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant