Provider Demographics
NPI:1053921577
Name:FEEHAN, AUDRA (OTD)
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:
Last Name:FEEHAN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11371 ARBOR ST APT C105
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-6695
Mailing Address - Country:US
Mailing Address - Phone:970-214-4758
Mailing Address - Fax:
Practice Address - Street 1:7045 STUART ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-5820
Practice Address - Country:US
Practice Address - Phone:303-427-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist