Healthcare Provider Details

I. General information

NPI: 1477102499
Provider Name (Legal Business Name): TAMARA SUE RIMER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 E PRENTICE AVE STE B14
GREENWOOD VILLAGE CO
80111-2758
US

IV. Provider business mailing address

PO BOX 1299
WHITEFISH MT
59937-1299
US

V. Phone/Fax

Practice location:
  • Phone: 303-601-8493
  • Fax:
Mailing address:
  • Phone: 303-601-8493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.00991261
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: