Provider Demographics
NPI:1942510326
Name:FUNK, SONDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:FUNK
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:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-0785
Mailing Address - Country:US
Mailing Address - Phone:970-668-0888
Mailing Address - Fax:
Practice Address - Street 1:360 PEAK ONE DR STE 190
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5868
Practice Address - Country:US
Practice Address - Phone:970-668-0888
Practice Address - Fax:970-668-0227
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003701225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist