Provider Demographics
NPI:1942756747
Name:POWERS, LAURA C (OT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:POWERS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 W SAINT VRAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2517
Mailing Address - Country:US
Mailing Address - Phone:719-629-6796
Mailing Address - Fax:719-313-9072
Practice Address - Street 1:2522 W SAINT VRAIN ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2517
Practice Address - Country:US
Practice Address - Phone:719-629-6796
Practice Address - Fax:719-313-9072
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0001018225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology