Provider Demographics
NPI:1922657782
Name:NEW, TANYA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:NEW
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 LAWRENCE ST APT 429
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2785
Mailing Address - Country:US
Mailing Address - Phone:248-917-1170
Mailing Address - Fax:
Practice Address - Street 1:501 THORNTON PKWY
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2101
Practice Address - Country:US
Practice Address - Phone:303-452-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005626225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist