=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114606142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VERONICA PLOEGER MSW, SWP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2023
-----------------------------------------------------
Last Update Date | 07/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 270 E FLATIRON CROSSING DR UNIT 1475
-----------------------------------------------------
City | BROOMFIELD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80021-8129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-916-0934
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 270 E FLATIRON CROSSING DR UNIT 1475
-----------------------------------------------------
City | BROOMFIELD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80021-8129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-916-0934
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | SWP.0001399
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------