Provider Demographics
NPI:1932511342
Name:POPE, JOAN (MS OCCUPATIONAL THER)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:MS OCCUPATIONAL THER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 FARRADAY RD
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8841
Mailing Address - Country:US
Mailing Address - Phone:970-247-0948
Mailing Address - Fax:
Practice Address - Street 1:1002 FARRADAY RD
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-8841
Practice Address - Country:US
Practice Address - Phone:970-247-0948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001017172V00000X
COOT.0001017172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker