Healthcare Provider Details
I. General information
NPI: 1326374364
Provider Name (Legal Business Name): ANDREW GABOR M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1405 FEDERAL BLVD
DENVER CO
80204-2211
US
IV. Provider business mailing address
1405 FEDERAL BLVD
DENVER CO
80204-2211
US
V. Phone/Fax
- Phone: 303-504-1500
- Fax: 303-825-1711
- Phone: 303-504-1500
- Fax: 303-825-1711
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 10817 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: