Provider Demographics
NPI:1619030764
Name:AGUILAR, AUDREY JANE (REGISTERED OCCUPATIO)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:JANE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:REGISTERED OCCUPATIO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221
Mailing Address - Country:US
Mailing Address - Phone:303-477-7857
Mailing Address - Fax:
Practice Address - Street 1:10717 JORDAN CT
Practice Address - Street 2:THERAPY CONSULTANTS
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-6494
Practice Address - Fax:303-805-0602
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C52938Medicare ID - Type Unspecified