Provider Demographics
NPI:1861764680
Name:PUGH, BETHANY (OTR)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:PUGH
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 1:1860 N LINCOLN ST FL 11
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2996
Mailing Address - Country:US
Mailing Address - Phone:720-423-2660
Mailing Address - Fax:
Practice Address - Street 1:1860 N LINCOLN ST FL 11
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2996
Practice Address - Country:US
Practice Address - Phone:720-423-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist