Provider Demographics
NPI:1265954028
Name:POTEAT, KAITLIN LEE
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:LEE
Last Name:POTEAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 S NAVAJO ST # A313
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-4456
Mailing Address - Country:US
Mailing Address - Phone:407-446-3059
Mailing Address - Fax:
Practice Address - Street 1:5951 MIDDLEFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7917
Practice Address - Country:US
Practice Address - Phone:518-396-9139
Practice Address - Fax:720-328-9920
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4955225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics