Provider Demographics
NPI:1437697760
Name:GUESS, ELLEN (OTRL)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:GUESS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13835 TEAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3980
Mailing Address - Country:US
Mailing Address - Phone:303-579-3060
Mailing Address - Fax:
Practice Address - Street 1:13123 EAST 16TH AVENUE
Practice Address - Street 2:B335 CHILDRENS HOSPITAL COLORADO
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-777-0902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO005883225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics