Provider Demographics
NPI:1023165073
Name:SCHLEIFER, KATHLEEN KYFFIN (MHS, OTR)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:KYFFIN
Last Name:SCHLEIFER
Suffix:
Gender:F
Credentials:MHS, OTR
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:KYFFIN
Other - Last Name:SCHLEIFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MHS, OTR
Mailing Address - Street 1:366 S HACIENDA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-3105
Mailing Address - Country:US
Mailing Address - Phone:719-547-9227
Mailing Address - Fax:719-561-9799
Practice Address - Street 1:366 S HACIENDA DEL SOL DR
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-3105
Practice Address - Country:US
Practice Address - Phone:719-547-9227
Practice Address - Fax:719-561-9799
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AA274134225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12283240Medicaid