Provider Demographics
NPI:1659173938
Name:PHILLIPS, KENDALL ANN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:ANN
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S SHERMAN ST APT 310
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-1648
Mailing Address - Country:US
Mailing Address - Phone:727-452-2848
Mailing Address - Fax:
Practice Address - Street 1:10 S SHERMAN ST APT 310
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1648
Practice Address - Country:US
Practice Address - Phone:727-452-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0008810225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist