Healthcare Provider Details

I. General information

NPI: 1053788406
Provider Name (Legal Business Name): CATHERINE MACE BURSON MS, BCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST SUITE 280
DENVER CO
80205-5503
US

IV. Provider business mailing address

10889 IDALIA ST
COMMERCE CITY CO
80022-9595
US

V. Phone/Fax

Practice location:
  • Phone: 720-754-4905
  • Fax: 720-754-4906
Mailing address:
  • Phone: 720-939-9224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: