Provider Demographics
NPI:1144867250
Name:LAROCCA, DENISE (OTD, MS, OTR/L, MS)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:LAROCCA
Suffix:
Gender:F
Credentials:OTD, MS, OTR/L, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637-B SOUTH BROADWAY
Mailing Address - Street 2:#142
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:303-355-0861
Mailing Address - Fax:
Practice Address - Street 1:2765 DARLEY AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6305
Practice Address - Country:US
Practice Address - Phone:303-819-1744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005326225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist