Basic Information
| Provider Information | |||||||||
| NPI: | 1053921577 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEEHAN | ||||||||
| FirstName: | AUDRA | ||||||||
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| Credential: | OTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11371 ARBOR ST APT C105 | ||||||||
| Address2: | |||||||||
| City: | FIRESTONE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805046695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702144758 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7045 STUART ST | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800305820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034277045 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2020 | ||||||||
| LastUpdateDate: | 08/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.