Healthcare Provider Details
I. General information
NPI: 1063806685
Provider Name (Legal Business Name): ESTHER AGUILA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2015
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2930 11TH AVE
EVANS CO
80620-1011
US
IV. Provider business mailing address
1300 N 17TH AVE
GREELEY CO
80631-9584
US
V. Phone/Fax
- Phone: 970-347-2120
- Fax:
- Phone: 970-347-2120
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
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: