Provider Demographics
NPI:1902922578
Name:RICHTER, LINDA DALE (PHD, OTR)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:DALE
Last Name:RICHTER
Suffix:
Gender:F
Credentials:PHD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 LIMON DR UNIT 258
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-7643
Mailing Address - Country:US
Mailing Address - Phone:970-481-8845
Mailing Address - Fax:
Practice Address - Street 1:2350 LIMON DR UNIT 258
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7643
Practice Address - Country:US
Practice Address - Phone:970-481-8845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC809255Medicare PIN
CO809255Medicare PIN