Provider Demographics
NPI:1053304873
Name:MASON, SHARON LYNN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:MASON
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LYNN
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:411 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:CO
Mailing Address - Zip Code:80821-2007
Mailing Address - Country:US
Mailing Address - Phone:719-648-3764
Mailing Address - Fax:
Practice Address - Street 1:411 5TH ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821-2007
Practice Address - Country:US
Practice Address - Phone:719-648-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1986225X00000X
NE827225X00000X
CA25745225X00000X
CO1686225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM87804221Medicaid
NMNM00Q167OtherBLUE CROSS BLUE SHIELD