Provider Demographics
NPI:1639176407
Name:EWERS-DENNISON, MARY E (OTR, CHT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:EWERS-DENNISON
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CENTER GREEN DR
Mailing Address - Street 2:110
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2364
Mailing Address - Country:US
Mailing Address - Phone:303-601-6666
Mailing Address - Fax:303-447-3390
Practice Address - Street 1:3000 CENTER GREEN DR
Practice Address - Street 2:110
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2364
Practice Address - Country:US
Practice Address - Phone:303-601-6666
Practice Address - Fax:303-447-3390
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA521369OtherOTR
9105000345OtherCERTIFIED HAND THERAPIST
AA521369OtherOTR