Healthcare Provider Details

I. General information

NPI: 1285260398
Provider Name (Legal Business Name): SARAH E. VEKSLER CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 LITTLE RAVEN ST UNIT 2-222
DENVER CO
80202-1765
US

IV. Provider business mailing address

1355 S ELM ST
DENVER CO
80222-3521
US

V. Phone/Fax

Practice location:
  • Phone: 469-333-1373
  • Fax:
Mailing address:
  • Phone: 469-333-1373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number313334
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: