Theresa Marie Diaz, OTR/L
Individual provider Active NPI Occupational Therapist · Colorado Springs, CO
NPI 1285876201 · NPPES record last updated Apr 10, 2009
Key facts
- NPI
- 1285876201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 1699 (CO)
- Practice address
- 5820 Flintridge Drive
Colorado Springs, CO 80918 - Phone
- (719) 599-7328
- Fax
- (719) 264-0227
- NPI assigned
- Apr 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1699 | CO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Above & Beyond Mobile Therapy LLC. | Past |
Accepting new patients | |
| Legacy Healthcare Services Inc | Occupational Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1699 | CO | Yes |
Addresses
Primary practice location
5820 Flintridge Drive
Colorado Springs, CO 80918
Mailing address
5820 Flintridge Dr
Colorado Springs, CO 80918-1883
Phone (719) 599-7328
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699 | Other | CO | STATE OF COLORADO LICENSURE |
Other providers in Colorado Springs, CO
- Jonathan Ray Diaz
- Kayla Joann Diaz
- Lindsey Meredith Diaz
- Lydia Diaz
- Noely Selina Diaz
- Veronica Diaz
- Jamie Marie Dibble
- Emily Dibernardo
- Kimberly Dibiase
- Sophie Callista Diblasio
All providers in Colorado Springs, CO · Occupational Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.