Provider Demographics
NPI:1053084483
Name:METHERD, KYLIE B (OTR/L)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:B
Last Name:METHERD
Suffix:
Gender:
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 1:4089 COUNTY ROAD 146
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:CO
Mailing Address - Zip Code:80107-8211
Mailing Address - Country:US
Mailing Address - Phone:720-587-9417
Mailing Address - Fax:
Practice Address - Street 1:19284 COTTONWOOD DR STE 203
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3881
Practice Address - Country:US
Practice Address - Phone:720-788-7365
Practice Address - Fax:720-294-0284
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008500225X00000X
COOT.0008803225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist