Provider Demographics
NPI:1952382574
Name:HEALY, VICKIE L (OT)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:L
Last Name:HEALY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 S DOWNING ST
Mailing Address - Street 2:SUITE 580
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5847
Mailing Address - Country:US
Mailing Address - Phone:303-777-2393
Mailing Address - Fax:303-871-7067
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:SUITE 580
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:303-777-2393
Practice Address - Fax:303-871-7067
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1131225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31184847Medicaid