Provider Demographics
NPI:1912493123
Name:HOFER, KATIE ALYSSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ALYSSA
Last Name:HOFER
Suffix:
Gender:F
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 1:9875 PROMINENT PEAK HTS APT 211
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-8628
Mailing Address - Country:US
Mailing Address - Phone:701-793-3188
Mailing Address - Fax:
Practice Address - Street 1:830 TENDERFOOT HILL RD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7372
Practice Address - Country:US
Practice Address - Phone:719-623-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO405054225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist