Provider Demographics
NPI:1548537046
Name:ARCHIBALD, LINDA CHARLOTTE (OTR)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CHARLOTTE
Last Name:ARCHIBALD
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 1:5890 S LOWELL WAY
Mailing Address - Street 2:#204
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2889
Mailing Address - Country:US
Mailing Address - Phone:719-761-1654
Mailing Address - Fax:
Practice Address - Street 1:5890 S LOWELL WAY
Practice Address - Street 2:204
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2889
Practice Address - Country:US
Practice Address - Phone:719-761-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA218297225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist