Provider Demographics
NPI:1891086450
Name:ARAGON, ROBERTA ANN (COTA, CPD)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ANN
Last Name:ARAGON
Suffix:
Gender:F
Credentials:COTA, CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 ONEAL AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-2833
Mailing Address - Country:US
Mailing Address - Phone:719-334-6909
Mailing Address - Fax:
Practice Address - Street 1:3261 ONEAL AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2833
Practice Address - Country:US
Practice Address - Phone:719-334-6909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO271084224Z00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant