Provider Demographics
NPI:1962452698
Name:GROGAN, LAURA MICHELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:GROGAN
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 1:1258 MARION ST
Mailing Address - Street 2:APT 202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2217
Mailing Address - Country:US
Mailing Address - Phone:303-844-7849
Mailing Address - Fax:303-844-2019
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:EVANS ARMY HOSPITAL OCCUPATIONAL THERAPY CLINIC
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-526-7110
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT586225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist