Provider Demographics
NPI:1922602267
Name:PAPSON, MINDA JO (OTR/L)
Entity Type:Individual
Prefix:
First Name:MINDA
Middle Name:JO
Last Name:PAPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W CORNWALL CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1161
Mailing Address - Country:US
Mailing Address - Phone:865-719-0114
Mailing Address - Fax:
Practice Address - Street 1:215 W CORNWALL CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1161
Practice Address - Country:US
Practice Address - Phone:865-719-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3444225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist