Outpatient Rehabilitation Therapists
Please see below for information on our amazing therapists across multiple disciplines. Click the blue buttons below to jump to that particular section.
Hand & Upper Extremity Specialist
Catherine Lowry, OTR/L, CHT
As a Certified Hand Therapist (CHT), Catherine is a specialized fabricator of custom orthoses and a provider of upper extremity rehabilitation, including non-surgical and post-surgical care.
With a diverse occupational therapy clinical background, she is experienced
in the treatment of orthopedic trauma, overuse injury and degenerative/systemic
disease processes. Her goal is to provide meaningful outcomes to her patients
through compassionate one-on-one treatment, thorough patient education and
robust home programs.
Education & Certifications
- Certified Hand Therapist, Hand Therapy Certification Commission (HTCC)
- Bachelor of Science in Occupational Therapy, University of Texas Health Science Center at San Antonio, San Antonio, TX
Occupational Therapists
Jared Alme, OTR/L
Jared attended occupational therapy school at Washington University in St. Louis. He has clinical experience treating a variety of neurologic and orthopedic conditions and is particularly interested in treating patients recovering from stroke, brain injuries and upper extremity injuries. He is passionate about a holistic approach to treatment, considering the physical, mental, social and spiritual needs of the individual. In his free time, Jared loves hiking, time with friends and family, reading, yoga and meditation.
Education
- Master of Science in Occupational Therapy, Washington University, St. Louis, MO
- Bachelor of Science in Integrative Physiology, University of Colorado Boulder, Boulder, CO
- Bachelor of Science in Psychology, University of Colorado Boulder, Boulder, CO
Ann Brexa, OTR/L
Ann has 40+ years of experience as an occupational therapist working in outpatient rehabilitation. For 18 years, she specialized as a hand therapist and continues to enjoy treating the hand and upper extremity. Ann has extensive experience working with the neurologic populations of traumatic brain injury, stroke and post-concussion.
She performs Safe Driver Assessments for those interested in returning to driving after injury. Ann is also experienced in ergonomic assessments and return-to-work evaluations. She has a broad clinical background, providing occupational therapy services for a variety of diagnoses. Ann is an avid skier and cyclist who has raised three active children and loves travel within and outside of the USA.
Education & Certifications
- CarFit Certification (enhance comfort, safety, and fit in vehicle), AAA, AARP and AOTA
- Bachelor of Science in Occupational Therapy, Colorado State University, Fort Collins, CO
Karen Stanisich, OTR/L, CLT
Karen has worked as an occupational therapist for nearly 40 years and joined BCH's therapy team 25 years go. Karen became a Certified Lymphedema Therapist (CLT) through the Klose Training and Consulting Group in 2008. At that training, Karen was certified in Jobst and Juzo measuring for garments. These certifications allow Karen to provide care to clients with multiple kinds of cancer, lymphedema or swelling in the arms or legs.
She has extensive experience in specialty areas, including concussion, brain injury, stroke and vision rehabilitation. Karen is a Parkinson Wellness Recovery | PWR!® trained therapist. Outside of work, Karen enjoys photography, hiking, kayaking, gardening and travel.
Education & Certifications
- Certified Lymphedema Therapist, Klose Training and Consulting Group
- CarFit Certification (enhance comfort, safety, and fit in vehicle), AAA, AARP and AOTA
- Bachelor of Science in Occupational Therapy, University of Puget Sound, Tacoma, WA
Physical Therapists
Annabel Bavage, PT, DPT,
CLT
Annabel is a pelvic floor specialist who treats men, women and trans people. Her practice focuses on pain and dysfunction in the pelvic floor, as well as muscular and joint conditions of the spine, pelvis and lower extremity.
Annabel’s therapeutic approach emphasizes exercise, manual therapy and lifestyle modification for resolution of pain and patients’ return to the activities they love. She has a special interest in biking and is experienced in providing bike fit recommendations for both mountain bikers and road cyclists. In her free time, Annabel enjoys spending time in the mountains both on foot and on bike.
Education & Certifications
- APTA Pelvic Health Physical Therapy Level 1-3 Course
- Certified Lymphedema Therapist, Klose Training and Consulting Group
- Doctor of Physical Therapy, University of Minnesota, Minneapolis, MN
- Bachelor of Arts, St. Olaf College, Northfield, MN
Juli R. Booton, PT, MS,Certified Tai Chi for Health Instructor
Juli began her work as a physical therapist in 1987. She specializes in the treatment of orthopedic and sports injuries, including acute knee injuries, shoulder rotator cuff problems, and cervical, thoracic and lumbar dysfunction. Juli is a certified Tai Chi for Health Instructor (TCHI) and has extensive experience in fall risk reduction. Outside of work, Juli enjoys mountain biking, skiing, playing with family and bible study.
Education & Certifications
- Orthopedic Excellence Certificate Program: The Spine, MedBridge
- Certification in Functional Dry Needling, KinetaCore
- Certified Tai Chi for Health Instructor, Consortium for Older Adult Wellness
- Master of Science in Kinesiology, University of Colorado, Boulder, CO
- Bachelor of Science in Physical Therapy, University of Texas Medical Branch, School of Allied Health Sciences, Galveston, TX
Steven DeGennaro, PT, MPT
Steve is a physical therapist with over 20 years of experience. He has extensive training in osteopathic manual therapy techniques, including craniosacral therapy, muscle energy technique, myofascial release, strain-counterstrain, and visceral manipulation.
Steve enjoys working with patients with a variety of neurologic and orthopedic diagnoses, including neck and back pain, headaches, trauma, concussions and traumatic brain injury. Using a holistic approach to treatment, Steve helps patients suffering from chronic pain, fibromyalgia and related diagnoses. Outside of work, Steve enjoys hiking, yoga and meditation, and playing guitar.
Education
- Master of Physical Therapy, Quinnipiac University, Hamden, CT
- Bachelor of Science in Health Science, Quinnipiac University, Hamden, CT
Cathy Fraser, PT
Cathy graduated from the University of Sydney (Australia) in 1988 with a Bachelor of Applied Science in Physiotherapy. In 1998, she received a Graduate Diploma in Manipulative Therapy from the University of Sydney. She has worked in numerous settings, including acute care, rehab, orthopedics and outpatient therapy. Cathy joined BCH in 1999. She worked for 16 years in BCH’s previous sports medicine department and, in 2015, joined the Outpatient Rehabilitation team.
For the past 25 years, her focus has been outpatient orthopedics. Cathy's skills include trigger point dry needling, manual therapy and functional exercise. She has extensive experience in evaluating and treating all spinal conditions, whiplash, shoulder injuries, hip injuries and knee injuries. She has wide experience with degenerative orthopedic conditions, as well as acute orthopedic diagnoses. Cathy has rehabilitated a wide variety of post-operative conditions, including hip, knee and shoulder replacement, ACL reconstruction, rotator cuff repairs, labral repairs of the hip and shoulder and spinal fusions. She has worked with all age groups, from teens to older adults and has an interest in treating EDS and scoliosis.
Over the years, Cathy has been a lifelong learner, completing many continuing education courses. Her philosophy when treating patients is to treat everybody with respect and actively engage them in the rehabilitation process. Her goal, when possible, is to return patients to the activities that they love doing. When not at work, Cathy enjoys horse riding, hiking and being in the beautiful Colorado outdoors.
Education & Certifications
- Certification in Functional Dry Needling, KinetaCore
- Graduate Diploma in Manipulative Therapy, University of Sydney, Australia
- Bachelor of Applied Science in Physiotherapy, University of Sydney, Australia
Cathy Holland, PT, MPT (Therapy Manager)
Cathy Holland is a manager of BCH's Outpatient Rehabilitation team. Cathy began her physical therapy career in 1994 at National Rehabilitation Hospital in Washington, D.C., where she worked with both inpatients and outpatients with neurologic and orthopedic involvement.
At BCH since 1998, Cathy is honored to work with an interdisciplinary team with tremendous depth to offer high-quality, comprehensive, evidence-based rehabilitation and wellness services to the community. A positive patient experience and optimal functional outcomes are daily goals she sets for the outpatient rehabilitation team. Outside of work, Cathy enjoys the great outdoors and active time with family and friends.
Education
- Master of Physical Therapy, University of Delaware, Newark, DE
- Bachelor of Arts in Biology, University of Virginia, Charlottesville, VA
Professional Associations
- American Physical Therapy Association
Nicole Hugus, PT, DPT, CSRS
Nicole moved to Colorado in 2011 and began working for BCH in the acute and inpatient rehabilitation settings. In 2013, she joined the outpatient rehabilitation team. In 2016, Nicole became a preeminent stroke clinician through completion of a rigorous set of courses and an examination culminating in the nationally recognized credentials of CSRS (Certified Stroke Rehabilitation Specialist). Also in 2016, she became dry needling certified.
During her physical therapy coursework at the University of Central Florida, she focused on fall prevention for seniors, specifically those who had suffered a stroke. Interests include stroke rehabilitation, vestibular dysfunction, neurotrauma and shoulder dysfunction. Nicole is skilled at incorporating balance, coordination, agility and core strengthening into treatment sessions, when appropriate. She believes in a proactive approach wherein education is vital to rehabilitative success and the overall health and safety of a patient. In her spare time, Nicole loves to explore the great outdoors.
Education & Certifications
- Certification in Functional Dry Needling, KinetaCore
- Doctor of Physical Therapy, University of Central Florida, Orlando, FL
- Bachelor of Science in Psychology, Florida State University, Tallahassee, FL
Professional Associations
- American Physical Therapy Association
Erin Jensen, PT, MPT
Erin has over 20 years of experience as a physical therapist. Her focus
is adult orthopedic diagnoses, including the ankle, knee, hip, shoulder
and spine. Erin’s therapeutic approach emphasizes exercise, manual
therapy and lifestyle modification for pain resolution to enable patients
to return to the life they love.
She enjoys building rapport with her patients, empowering them to be proactive with their overall health, and working with them toward their goals. She uses functional dry needling and Graston Technique® to complement her manual therapy skills and focuses on functional exercise programs. Originally from California, Erin traded the beach for her love of the mountains. Outside of work, Erin enjoys hot yoga, hiking, skiing, camping and staying active with her family.
Education & Certifications
- Certification in Graston Technique®
- Certification in Functional Dry Needling, KinetaCore
- Master of Physical Therapy, California State University, Fresno, CA
- Bachelor of Science in Kinesiology, California State University, Fresno, CA
Tammy Johnson, PT, OCS
Tammy has over 20 years of experience as a physical therapist. As a board-certified orthopaedic clinical specialist (OCS), her focus is adult orthopedic diagnoses, including hip, knee, ankle, shoulder, low back, neck and more. Tammy has experience with numerous types of manual therapy, including trigger point dry needling, myofascial decompression (cupping), joint mobilizations and craniosacral therapy.
She believes that patient education of anatomy and condition is essential to the rehabilitation process. Her goal is to empower each patient by using education, exercise, manual therapy and plenty of encouragement to improve activity level and function.Outside the clinic, Tammy enjoys yoga, hiking, camping, reading and cooking.
Education & Certifications
- Board-Certified Orthopaedic Clinical Specialist, American Board of Physical Therapy Specialties
- Craniosacral I and II Certification, Upledger Institute
- Certification in Dry Needling I and II, American Academy of Manipulative Therapy
- Aquatic Clinical Competency Certification, APTA
- Registered Yoga teacher, Yoga Alliance
- Bachelor of Science in Physical Therapy, University of Cincinnati, Cincinnati, OH
Jennifer Lieb, PT,
MSPT, CPI, CLT-LANA
Jennifer has worked as a physical therapist since 1996. Her specialties include breast cancer rehabilitation, lymphedema, Pilates and orthopedics. Advanced certifications include Certified Lymphedema Therapist, Lymphology Association of North America and Certified Pilates Instructor. Outside of work, Jennifer enjoys spending time with her family, traveling, walking her dogs and time outdoors.
Education & Certifications
- Yoga Alliance Certification, 200-hour
- Certification in Functional Dry Needling, KinetaCore
- Certified Lymphedema Therapist, Klose Training and Consulting Group
- Certified Practitioner of Pilates Rehabilitation, Polestar Pilates
- Master of Science in Physical Therapy, University of Colorado Health Sciences Center, Denver, CO
- Bachelor of Science in Kinesiology, University of Colorado Boulder, Boulder
Maureen Pelsmaeker, PT, MSPT
Maureen has 35+ years of experience as a physical therapist. She has a background in kinesiology and published research in muscle physiology. Maureen has worked in a variety of settings, including acute care, inpatient rehabilitation and outpatient rehabilitation. She has expertise in spinal disorders and general orthopedics and has rehabilitated a wide variety of post-surgical orthopedic conditions (e.g., joint replacements and rotator cuff repairs), along with neurological conditions.
Maureen has been certified in trigger point dry needling since 2009. She completed her certification in vestibular rehabilitation in 2015 and works with patients with balance, concussion, and vestibular disorders. Maureen has always been passionate about learning and continues to update her skills and stay current on research in the field. She believes in a holistic approach to patient care and views therapy as a team approach with each patient. Outside of work, she enjoys her family and has a passion for travel, skiing and the outdoors.
Education & Certifications
- Certification in Functional Dry Needling, KinetaCore
- Master of Science in Physical Therapy, Hahnemann University, Philadelphia, PA
- Bachelor of Science in Kinesiology, UCLA, Los Angeles, CA
Steven Pochron, PT, DPT
Steven earned his Doctor of Physical Therapy degree from Indiana State University and is originally from the suburbs of Chicago. He has clinical experience treating a variety of orthopedic conditions and is particularly interested in treating patients with oncologic related conditions, lower extremity conditions, cervical pain and Parkinson’s disease.
Steven is passionate about total body health and wellness. He strives to treat the patient as a whole, so they can continue living their lives the way they want to. In his free time, Steven loves to hike with his dog, Koda, explore the food scene of Denver and visit the many outdoor attractions that Colorado has to offer.
Education and Certifications
- Doctor of Physical Therapy, Indiana State University, Terre Haute, IN
- Graston Technique® M1
- LSVT BIG®, LSVT® Global
- Bachelor of Science in Kinesiology, University of Illinois at Urbana Champaign, IL
Professional Associations
- American Physical Therapy Association
- APTA Geriatric and Oncologic sections
Mary Richardson, PT, MSP Specialist
Mary has worked as a physical therapist since 1996 and joined BCH's outpatient rehabilitation team in 2002. In 2005, she completed a three-month intensive training program to become a certified FallProof™ instructor. Mary’s specialty areas include Parkinson’s disease, as a Parkinson Wellness Recovery | PWR!® trained clinician, women’s health with special training in prenatal and post-partum care, balance and fall risk reduction, and orthopedics (both spine and extremities). Outside of work, Mary enjoys mountain biking, hiking, camping, and family time.
Education & Certifications
- Certified FallProof™ Instructor
- Certification in Functional Dry Needling, KinetaCore
- Master of Science in Physical Therapy, University of Colorado Health Sciences Center, Denver, CO
- Bachelor of Science in Geology, Colorado State University, Fort Collins, CO
Suzanne Segalowitz, PT, MSPT, CSRS, CLT
Suzanne began her career at Spaulding Rehabilitation Hospital in Boston working with patients with neurologic involvement, including brain injury, stroke and spinal cord injury. In 2012, she obtained Neuro-IFRAH certification to expand treatment options for patients with hemiplegia. Then in 2022, she became a Certified Stroke Rehabilitation Specialist. In 2022, Suzanne also became a certified Lymphedema Therapist through Klose Training and received training in breast cancer rehabilitation.
She offers a seating and mobility clinic, where she works closely with clients and vendors to optimize seating and functional mobility. Outside of work, Suzanne enjoys hiking, cycling, running, and climbing.
Education & Certifications
- Certified Lymphedema Therapist, Klose Training and Consulting Group
- Certified Stroke Rehabilitation Specialist, Neurorecovery UnlimitedTM
- Certification in Functional Dry Needling, KinetaCore
- Neuro-IFRAH trained in Treatment and Management of Adults with Hemiplegia from a Stroke or Brain Injury, Neuro-IFRAH Organization
- Master of Science in Physical Therapy, University of Connecticut, Mansfield, CT
- Bachelor of Science, University of Connecticut, Mansfield, CT
Education & Certifications
- Certified Lymphedema Therapist. Klose Training and Consulting Group, 2022.
- Certified Stroke Rehabilitation Specialist. Neurorecovery UnlimitedTM, 2022.
- Certification in Functional Dry Needling. KinetaCore, 2015.
- Neuro-IFRAH Certification in Treatment and Management of Adults with Hemiplegia from a Stroke or Brain Injury. Neuro-IFRAH Organization, 2012.
- Master of Science in Physical Therapy. University of Connecticut, Mansfield, CT, 2009.
- Bachelor of Science. University of Connecticut, Mansfield, CT, 2008.
Brandy Whitney, PT, DPT, CLT, CMT, Board-Certified Clinical Specialist
in Oncologic Physical Therapy
Brandy’s specialty areas include oncology rehabilitation (post breast reconstruction, lumpectomy, radiation and chemotherapy), vestibular dysfunction, orthopedic injuries and soft tissue techniques. Brandy is an active participant in BCH’s breast cancer conferences and provides educational outreach through community lectures. Her advanced certifications include Board-Certified Clinical Specialist in Oncologic Physical Therapy, Certified Lymphedema Therapist and trigger point dry needling. Outside of work, Brandy enjoys telemark skiing, cycling, running and cooking.
Education & Certifications
- Board-Certified Clinical Specialist in Oncologic Physical Therapy, American Board of Physical Therapy Specialties
- Doctor of Physical Therapy, University of Nevada, Las Vegas, NV
- Certification in Functional Dry Needling, KinetaCore
- Certified Lymphedema Therapist (Upper Extremity), Klose Training and Consulting Group
- Master of Science in Physical Therapy, University of Nevada, Las Vegas, NV
- Certification in Massage Therapy, Massage Therapy Institute of Colorado, Denver, CO
- Bachelor of Science in Exercise Sport Science, Colorado State University
Professional Associations
- Board of Directors for PIMA's Physical Therapy Assistant Program, Westminster, CO
Joanna Zemmelman, PT, CLT
Joanna has been working as a physical therapist since 1994 and joined BCH's outpatient rehabilitation team in 2000. She has worked in a variety of settings prior to joining BCH, including inpatient rehabilitation, outpatient rehabilitation and private practice. Joanna became a Certified Lymphedema Therapist through the Klose Training and Consulting Group in 2015 and a PORi-Certified (Physiological Oncology Rehabilitation Institute) Head and Neck Cancer Rehabilitation Therapist in 2018.
She is a founding member of BCH’s interdisciplinary head and neck cancer team. Her additional areas of focus include general oncology, lymphedema management and orthopedics. Joanna received training from the renowned Mariano Rocabado for treatment of temporomandibular joint dysfunction (TMJ) dysfunctions and headache management. Outside of work, she enjoys jogging, hot yoga, music festivals, and time with her family.
Education & Certification
- Certified Head and Neck Cancer Rehabilitation Therapist, Physiological Oncology Rehabilitation Institute (PORi)
- Certified Lymphedema Therapist, Klose Training and Consulting Group
- Mariano Rocabado Trained TMJ Therapist
- Bachelor of Science in Physical Therapy, West Virginia University
Publications
- Miller, NH, Miller, DJ, Goldberg (Zemmelman), JL, Physical Therapist Examination, Evaluation and Intervention for a Patient with West Nile Virus Paralysis, Journal of American Physical Therapy Association, 2006, Vol 86, No. 6, pp. 843-856
Speech Therapists
Michelle Becker, MS, CCC-SLP
Since 1991, Michelle has worked as a speech-language pathologist with adults in the areas of speech, language, cognitive/communicative and swallowing disorders. Michelle has experience working with the adult population in acute care, inpatient and outpatient rehabilitation settings, home health care and skilled nursing facilities. She is certified as a VitalStim® provider for swallowing therapy and, in 2012, was certified in the Lee Silverman Voice Treatment LOUD® method for individuals with Parkinson’s disease. She has been a guest lecturer regarding the speech-pathology profession at Metropolitan State University in Denver to students in the undergraduate program and has presented at Boulder Senior Law Day regarding aging and cognition. She describes patient and family education as the backbone of her therapy approach.
Education & Certifications
- Lee Silverman Voice Treatment (LSVT®) Loud Certification, LSVT® Global
- Certification in VitalStim®: Neuromuscular Electric Stimulation (NMES), CIAO Seminars
- Master of Science, Communication Sciences and Disorders, University of Wisconsin, Milwaukee, WI
- Bachelor of Science in Secondary Education/Communication Disorders, University of Wisconsin, River Falls, WI
Professional Associations
- Member of American Speech-Language-Hearing Association (ASHA) with Certificate of Clinical Competence (CCC)
- Member of ASHA Special Interest Groups in Neurogenic Communication Disorders, Swallowing & Swallowing Disorders (Dysphagia), and Gerontology
Karen Brady, MS, CCC-SLP
Karen has been with BCH since 2012 and has over 14 years of experience as a speech-language pathologist. Her primary areas of focus are serving those who are recovering from brain injuries, strokes, cancer, people with Parkinson’s disease and those with voice and swallowing impairments. She has experience working with adult populations in the acute and inpatient rehabilitation settings. Karen is both VitalStim® and SPEAK OUT!® certified, and is a PORi-Certified (Physiological Oncology Rehabilitation Institute) Head and Neck Cancer Rehabilitation Therapist, with specific proficiency in manual therapies for problems with voice, swallowing, lymphedema and facial paralysis.
She is a founding member of BCH’s interdisciplinary head and neck cancer team. Karen co-teaches a community class about Living with Cancer Related Brain Fog, as well as community presentations about living well with Parkinson’s disease. She was introduced to the speech-language pathology field through music and singing and has facilitated choirs for people living with aphasia. She believes in a compassionate, holistic collaboration with her patients and prioritizes education for success. Outside of work, Karen enjoys family, music and active adventures.
Education & Certifications
- SPEAK OUT!® Therapy for Parkinson’s Certified Provider, Parkinson Voice Project
- Manual Therapy for Voice, Swallowing and Bell’s Palsy, CIAO Seminars
- Certification in VitalStim®: Neuromuscular Electric Stimulation (NMES), CIAO Seminars
- Certified Head and Neck Cancer Rehabilitation Therapist, Physiological Oncology Rehabilitation Institute (PORi)
- Urban Zen Integrative Therapist, Boulder Community Health
- Lee Silverman Voice Treatment (LSVT®) Loud trained, LSVT® Global
- Master of Science, Speech Pathology and Audiology, California State University, East Bay, Hayward CA
- Bachelor of Arts, Radio and Television, San Francisco State University, San Francisco, CA
Professional Associations
- Member of American Speech-Language-Hearing Association (ASHA) with Certificate of Clinical Competence (CCC)
Susan Elling, MA, CCC-SLP
Susan is a speech-language pathologist with over 30 years of experience. She has worked in a variety of settings, including hospital-based outpatient clinics, home care, early intervention, schools and private practice. Her areas of focus include serving patients with speech, language, cognitive, voice and swallowing impairments.
Outside of work, Susan enjoys travel, biking, hiking, meditation and attending local festivals of film and music. She has been a lifelong learner of using play in her work with all ages and is passionate about toy lending libraries.
Education & Certifications
- Orton-Gillingham Training for Reading Assessment and Instruction
- Certified Instructor: Accent Modification/Reduction, The Institute of Language and Phonology Training Division
- Master of Arts in Communication Disorders and Speech Science, University of Colorado-Boulder, Boulder, CO
- Bachelor of Arts in Communication Disorders and Speech Science, University of Colorado-Boulder, Boulder, CO.
Professional Associations
- Member of American Speech-Language-Hearing Association (ASHA) with Certificate of Clinical Competence (CCC)
Bethany Firstbrook, MA, CCC-SLP
Bethany received her master’s degree in speech-language pathology from the University of Maryland in 2010. She traveled as a speech-language pathologist for three years across Maryland, Texas, and Colorado, and has worked in a variety of settings with patients of all ages. Bethany joined the BCH Outpatient Rehabilitation and Acute Care teams in 2018. Currently, her primary areas of focus are serving patients with head and neck cancer, brain injuries and swallowing impairments. She is a certified VitalStim® provider for swallowing therapy and a PORi-Certified (Physiological Oncology Rehabilitation Institute) Head and Neck Cancer Rehabilitation Therapist.
Education & Certifications
- Certified Head and Neck Cancer Rehabilitation Therapist, Physiological Oncology Rehabilitation Institute (PORi)
- Certification in VitalStim®: Neuromuscular Electric Stimulation (NMES), CIAO Seminars
- Master of Arts in Speech-Language Pathology, University of Maryland, College Park, MD
- Bachelor of Science in Speech-Language Pathology and Audiology, Towson University, Towson, MD
Professional Associations
- Member of American Speech-Language-Hearing Association (ASHA) with Certificate of Clinical Competence (CCC)