MEDICARE: LAUREN A MAPLES PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PSY-3995	CO

General Provider Information

NPI Number	:	1588959274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN A MAPLES PH.D.

Provider Business Mailing Address
First Line	:	343 W DRAKE RD
Second Line	:	SUITE 200
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-430-6615
Fax Number	:	970-482-7300

Provider Business Practice Location Address
First Line	:	343 W DRAKE RD
Second Line	:	SUITE 200
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-430-6615
Fax Number	:	970-482-7300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2011
Last Update Date	:	03/27/2015

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