Provider Demographics
NPI:1457070757
Name:STEPHENS, AUBRETTE HELEN (COTA/L)
Entity type:Individual
Prefix:
First Name:AUBRETTE
Middle Name:HELEN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 DIPLOMAT VW APT 1602
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-8349
Mailing Address - Country:US
Mailing Address - Phone:785-443-0061
Mailing Address - Fax:
Practice Address - Street 1:2365 PATRIOT HTS
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-5122
Practice Address - Country:US
Practice Address - Phone:719-667-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTA.0001604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist