Provider Demographics
NPI:1144292319
Name:ANDERSON, MARY RENEE (OTR CHT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:RENEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:OTR CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9440 S HACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129
Mailing Address - Country:US
Mailing Address - Phone:303-791-8604
Mailing Address - Fax:
Practice Address - Street 1:2535 S DOWNING
Practice Address - Street 2:#580
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210
Practice Address - Country:US
Practice Address - Phone:303-777-2393
Practice Address - Fax:303-871-7067
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist