Healthcare Provider Details

I. General information

NPI: 1134853625
Provider Name (Legal Business Name): LORI ANN HASSANZADEH-ASKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LORI ROMERO

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 SAWYER DR STE 100
DURANGO CO
81303-3409
US

IV. Provider business mailing address

PO BOX 1328
DURANGO CO
81302-1328
US

V. Phone/Fax

Practice location:
  • Phone: 970-259-2162
  • Fax: 970-335-2447
Mailing address:
  • Phone: 970-335-2238
  • Fax: 970-335-2438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0018389
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: