Provider Demographics
NPI:1518337310
Name:DANIEL, JOANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 BIG VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1035
Mailing Address - Country:US
Mailing Address - Phone:719-305-8102
Mailing Address - Fax:719-305-8702
Practice Address - Street 1:175 S UNION BLVD STE 255
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3126
Practice Address - Country:US
Practice Address - Phone:719-305-8000
Practice Address - Fax:719-305-8702
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0002544225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist