Provider Demographics
NPI:1831305069
Name:SIEMERS, TAMARA KIM (OTR)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:KIM
Last Name:SIEMERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 MOCKINGBIRD VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8977
Mailing Address - Country:US
Mailing Address - Phone:970-259-2558
Mailing Address - Fax:
Practice Address - Street 1:2141 MOCKINGBIRD VALLEY CT
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8977
Practice Address - Country:US
Practice Address - Phone:970-259-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95435051Medicaid