Healthcare Provider Details

I. General information

NPI: 1275782096
Provider Name (Legal Business Name): CHRISTINE VICTORIA TALAGA MORGAN M.A., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 26TH ST STE 1D
BOULDER CO
80302
US

IV. Provider business mailing address

1909 26TH ST STE 1D
BOULDER CO
80302-5707
US

V. Phone/Fax

Practice location:
  • Phone: 303-775-1300
  • Fax: 303-449-1967
Mailing address:
  • Phone: 303-775-1300
  • Fax: 303-449-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2141
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: