Mary Lou L Banning, COTA
Individual provider Active NPI Occupational Therapy Assistant · Brighton, CO
NPI 1972848927 · NPPES record last updated Dec 3, 2012
Key facts
- NPI
- 1972848927
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- AA265447 (CO)
- Practice address
- 4411 Mt Princeton St
Brighton, CO 80601-6547 - Phone
- (303) 503-5739
- NPI assigned
- Dec 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA265447 | CO | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | AA265447 | CO | Yes |
Addresses
Primary practice location
4411 Mt Princeton St
Brighton, CO 80601-6547
Mailing address
4411 Mt Princeton St
Brighton, CO 80601-6547
Phone (303) 503-5739
Other providers in Brighton, CO
- Leon Calvin Baber
- Balanced Life Chiropractic, LLC
- Bryce Anders Baldwin
- Shelbie L Banister
- Brian Thomas Banka
- Jennifer Barber
- Kelsey Marie Barber
- Kevin Barnes
- Mayjean Davis Barnes
- Victoria Bartter
All providers in Brighton, CO · Occupational Therapy Assistant in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2012. 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.