Healthcare Provider Details

I. General information

NPI: 1457484016
Provider Name (Legal Business Name): ANDREA BEGIN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 MAPLETON AVE
BOULDER CO
80304-3979
US

IV. Provider business mailing address

311 MAPLETON AVE
BOULDER CO
80304-3979
US

V. Phone/Fax

Practice location:
  • Phone: 303-441-2393
  • Fax:
Mailing address:
  • Phone: 303-441-2393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: