Basic Information
| Provider Information | |||||||||
| NPI: | 1457070757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEPHENS | ||||||||
| FirstName: | AUBRETTE | ||||||||
| MiddleName: | HELEN | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1940 DIPLOMAT VW APT 1602 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809058349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7854430061 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2365 PATRIOT HTS | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809045122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196675360 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2022 | ||||||||
| LastUpdateDate: | 08/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OTA.0001604 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.