Provider Demographics
NPI:1053523324
Name:BUTLER, JANET LEE (OT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 BLANCA CT
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-1023
Mailing Address - Country:US
Mailing Address - Phone:303-216-9353
Mailing Address - Fax:303-216-9354
Practice Address - Street 1:5900 BLANCA CT
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-1023
Practice Address - Country:US
Practice Address - Phone:303-216-9353
Practice Address - Fax:303-216-9354
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO989541174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82206511Medicaid