Healthcare Provider Details

I. General information

NPI: 1295730463
Provider Name (Legal Business Name): DENISE EILEEN WUENSCH L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 E 9TH AVE STE 490
DENVER CO
80203-2741
US

IV. Provider business mailing address

190 E 9TH AVE STE 490
DENVER CO
80203-2741
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-8675
  • Fax: 303-757-7370
Mailing address:
  • Phone: 303-839-8675
  • Fax: 303-757-7370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number987029
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: