Provider Demographics
NPI:1477185395
Name:REYNOLDS, SHANNON (OTD, OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:OTD, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 INVERNESS DR E STE 120
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5172
Mailing Address - Country:US
Mailing Address - Phone:303-744-7078
Mailing Address - Fax:
Practice Address - Street 1:145 INVERNESS DR E STE 120
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5172
Practice Address - Country:US
Practice Address - Phone:303-744-7078
Practice Address - Fax:303-996-3335
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006319225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist