Provider Demographics
NPI:1780433920
Name:BRANDHAGEN, ABBIE (OTD R/L)
Entity type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:
Last Name:BRANDHAGEN
Suffix:
Gender:F
Credentials:OTD R/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19501 E MAINSTREET STE 200
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7408
Mailing Address - Country:US
Mailing Address - Phone:303-479-3633
Mailing Address - Fax:
Practice Address - Street 1:19501 E MAINSTREET STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7408
Practice Address - Country:US
Practice Address - Phone:303-479-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0008354225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist