Provider Demographics
NPI:1982850731
Name:MYERS, SHARLEEN RENEE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:SHARLEEN
Middle Name:RENEE
Last Name:MYERS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8472 COUNTY LANE 17
Mailing Address - Street 2:
Mailing Address - City:ORDWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81063-9722
Mailing Address - Country:US
Mailing Address - Phone:719-267-8957
Mailing Address - Fax:
Practice Address - Street 1:401 IDAHO AVE
Practice Address - Street 2:
Practice Address - City:ORDWAY
Practice Address - State:CO
Practice Address - Zip Code:81063-1328
Practice Address - Country:US
Practice Address - Phone:719-267-3561
Practice Address - Fax:719-267-3441
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO990364224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant