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NPI Code Detail

MEDICARE: MAYA NATH MA

MEDICARE:   MAYA  NATH  MA
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
1101YM0800XMental Health CounselorNLC.0109811CO

General Provider Information

NPI Number : 1740888163
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA NATH MA
Provider Business Mailing Address
First Line : 1630 30TH STREET
Second Line : SUITE A, BOX 276
City : BOULDER
State : CO
Zip : 80301
Country : US
Telephone Number : 802-734-6441
Fax Number :
Provider Business Practice Location Address
First Line : 1554 N EMERSON ST UNIT 8
Second Line :
City : DENVER
State : CO
Zip : 80218-1450
Country : US
Telephone Number : 802-734-6441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2020
Last Update Date : 10/16/2020

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Directions to “ MAYA NATH MA” Practice Location

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