Healthcare Provider Details

I. General information

NPI: 1336343086
Provider Name (Legal Business Name): CHRISTINE ZWART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 29TH ST
BOULDER CO
80301-1202
US

IV. Provider business mailing address

2730 29TH ST
BOULDER CO
80301-1202
US

V. Phone/Fax

Practice location:
  • Phone: 720-201-5523
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1814
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC-029548
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: