Healthcare Provider Details

I. General information

NPI: 1659679173
Provider Name (Legal Business Name): HEATHER ENYEART MSW,LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 03/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST 116A-2
DENVER CO
80220-3808
US

IV. Provider business mailing address

312 APACHE PL
LOCHBUIE CO
80603-5714
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax: 303-393-5012
Mailing address:
  • Phone: 303-835-2911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number832
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: