Provider Demographics
NPI:1932806205
Name:PERRY, THERESA (OTR)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:PERRY
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 1:7395 W GRANT RANCH BLVD APT 1215
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2674
Mailing Address - Country:US
Mailing Address - Phone:720-244-9719
Mailing Address - Fax:
Practice Address - Street 1:7395 W GRANT RANCH BLVD APT 1215
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2674
Practice Address - Country:US
Practice Address - Phone:720-244-9719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0001414225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist