Provider Demographics
NPI:1760208748
Name:COX, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 S BANNOCK ST APT 309
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-3661
Mailing Address - Country:US
Mailing Address - Phone:918-510-3925
Mailing Address - Fax:
Practice Address - Street 1:1895 S BANNOCK ST APT 309
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-3661
Practice Address - Country:US
Practice Address - Phone:918-510-3925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0004361225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification