Healthcare Provider Details

I. General information

NPI: 1184128308
Provider Name (Legal Business Name): TIFFANY BARRIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 TENNYSON ST
DENVER CO
80212-3029
US

IV. Provider business mailing address

2205 LARIMER ST APT 313
DENVER CO
80205-2049
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-2541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW.0009921870
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: