Provider Demographics
NPI:1982312377
Name:TEEL, BRIDGET C (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:C
Last Name:TEEL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3792 VINEYARD CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-6124
Mailing Address - Country:US
Mailing Address - Phone:918-894-1277
Mailing Address - Fax:
Practice Address - Street 1:6650 S CALHAN RD
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-9394
Practice Address - Country:US
Practice Address - Phone:719-229-6596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0007511225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist