Healthcare Provider Details

I. General information

NPI: 1497544894
Provider Name (Legal Business Name): DEQUAN CYRELL ENZOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8773 RIDGELINE BLVD
HIGHLANDS RANCH CO
80129-2381
US

IV. Provider business mailing address

2500 17TH ST UNIT 418
DENVER CO
80211-3947
US

V. Phone/Fax

Practice location:
  • Phone: 303-683-7836
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: