Basic Information
| Provider Information | |||||||||
| NPI: | 1518587666 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ERB-TREFILEK | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MOT OTR/L | ||||||||
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| OtherOrganizationType: | |||||||||
| OtherLastName: | ERB | ||||||||
| OtherFirstName: | ELIZABETH | ||||||||
| OtherMiddleName: | NICOLE | ||||||||
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| OtherCredential: | MOT OTR/L | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1424 GAYLORD ST APT 3 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802062122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307152903 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11600 W 2ND PL | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203210000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2020 | ||||||||
| LastUpdateDate: | 04/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT.0005000 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 31005754A | 01 | IN | INDIANA PROFESSIONAL LICENSING AGENCY- OCCUPATIONAL THERAPY COMMITTEE | OTHER | OT.0005000 | 01 | CO | COLORADO DIVISION OF PROFESSIONS AND OCCUPATIONS | OTHER |