Provider Demographics
NPI:1770773772
Name:BIERSTETEL, ERIN D (COTA)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:D
Last Name:BIERSTETEL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 S GILPIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2616
Mailing Address - Country:US
Mailing Address - Phone:517-927-6558
Mailing Address - Fax:
Practice Address - Street 1:427 S GILPIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2616
Practice Address - Country:US
Practice Address - Phone:517-927-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202006546171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5202006546OtherCERTIFIED OCCUPATIONAL TH