Provider Demographics
NPI:1952591505
Name:GILILLAND, SHIRLEY HAYDEN (MS,OTR)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:HAYDEN
Last Name:GILILLAND
Suffix:
Gender:F
Credentials:MS,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 S RIFLE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3210
Mailing Address - Country:US
Mailing Address - Phone:303-208-4391
Mailing Address - Fax:
Practice Address - Street 1:823 S RIFLE WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3210
Practice Address - Country:US
Practice Address - Phone:303-208-4391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA226548225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist