Healthcare Provider Details

I. General information

NPI: 1437912722
Provider Name (Legal Business Name): EMILY CARLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 S BELLAIRE ST STE 390
DENVER CO
80222-4350
US

IV. Provider business mailing address

1064 GARFIELD ST
DENVER CO
80206-3511
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-4244
  • Fax:
Mailing address:
  • Phone: 970-485-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: