Provider Demographics
NPI:1962545756
Name:HLAVATY HAAS, TARA (OTR)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:HLAVATY HAAS
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 1:8155 E FAIRMOUNT DR
Mailing Address - Street 2:#2212
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6839
Mailing Address - Country:US
Mailing Address - Phone:303-916-3626
Mailing Address - Fax:
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:STE 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:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1062707225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand