Provider Demographics
NPI:1629725239
Name:REYES, GERARDO DANIEL (OTR/L)
Entity type:Individual
Prefix:MR
First Name:GERARDO
Middle Name:DANIEL
Last Name:REYES
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 1/2 N TEJON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1434
Mailing Address - Country:US
Mailing Address - Phone:719-301-0218
Mailing Address - Fax:
Practice Address - Street 1:110 1/2 N TEJON ST STE 204
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1434
Practice Address - Country:US
Practice Address - Phone:719-301-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0007254225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist