Healthcare Provider Details

I. General information

NPI: 1104556877
Provider Name (Legal Business Name): ANNA MAESTAS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 KING ST
DENVER CO
80219-1326
US

IV. Provider business mailing address

2620 S PARKER RD STE 185
AURORA CO
80014-1626
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-4100
  • Fax:
Mailing address:
  • Phone: 720-335-8028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: