Provider Demographics
NPI:1548434574
Name:LAVECK, EMILY ELIZABETH (OTR)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:LAVECK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3966 S BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-4602
Mailing Address - Country:US
Mailing Address - Phone:303-550-0688
Mailing Address - Fax:
Practice Address - Street 1:2701 W 84TH AVE STE 133
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3847
Practice Address - Country:US
Practice Address - Phone:720-441-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003716225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist