Healthcare Provider Details

I. General information

NPI: 1053958868
Provider Name (Legal Business Name): KAREN M QUIGLEY MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2019
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S BROADWAY ST
BOULDER CO
80305-5963
US

IV. Provider business mailing address

5200 LAUREL AVE
BOULDER CO
80303-2848
US

V. Phone/Fax

Practice location:
  • Phone: 520-955-9503
  • Fax:
Mailing address:
  • Phone: 520-955-9503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number00001681
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2048
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: