Provider Demographics
NPI:1912905225
Name:CUMMINGS, BRENDA KAYE (OTR, CHT)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:KAYE
Last Name:CUMMINGS
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 1:3744 S TIMBERLINE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4333
Mailing Address - Country:US
Mailing Address - Phone:970-204-4263
Mailing Address - Fax:970-204-4552
Practice Address - Street 1:3744 S TIMBERLINE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4333
Practice Address - Country:US
Practice Address - Phone:970-204-4263
Practice Address - Fax:970-204-4552
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO547133225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73735574Medicaid
CO473838Medicare PIN