Provider Demographics
NPI:1457596835
Name:DYCKOVA, KARYN ALISON (OTR)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:ALISON
Last Name:DYCKOVA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 DRESSAGE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-7953
Mailing Address - Country:US
Mailing Address - Phone:303-324-2702
Mailing Address - Fax:
Practice Address - Street 1:8033 DRESSAGE RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-7953
Practice Address - Country:US
Practice Address - Phone:303-324-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1064225X00000X
COOT.0001064225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist