Provider Demographics
NPI:1467665059
Name:KUTE, AMANDA (OTD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:KUTE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 PANTHER WAY
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-3165
Mailing Address - Country:US
Mailing Address - Phone:719-452-1618
Mailing Address - Fax:
Practice Address - Street 1:155 PANTHER WAY
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-3165
Practice Address - Country:US
Practice Address - Phone:719-452-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2588225XP0200X
VA0119003764174400000X
224ZF0002X
COOT.0002588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No174400000XOther Service ProvidersSpecialist
No224ZF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantFeeding, Eating & Swallowing
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0119003764OtherOT
CO2588OtherOT STATE LICENSE
CO26635372Medicaid