Basic Information
| Provider Information | |||||||||
| NPI: | 1023007804 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | VICTORIA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 GOLDEN RIDGE RD | ||||||||
| Address2: | STE. 250 | ||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804019541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032331223 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 660 GOLDEN RIDGE RD | ||||||||
| Address2: | STE. 250 | ||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804019541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032331223 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2005 | ||||||||
| LastUpdateDate: | 07/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 2240 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 56035543 | 05 | CO | MEDICAID |