Basic Information
| Provider Information | |||||||||
| NPI: | 1669461539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAIGHT | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 720 S COLORADO BLVD | ||||||||
| Address2: | SUITE 200-A, DEPT 914 | ||||||||
| City: | GLENDALE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802461912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035848000 | ||||||||
| FaxNumber: | 3035848141 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 E HAMPDEN AVE | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801132546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037889200 | ||||||||
| FaxNumber: | 3037889265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 02/11/2008 | ||||||||
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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 | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 066615 | 01 | CO | MEDICARE GROUP # | OTHER |