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General NPI Number Information
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NPI Number | 1164864476
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Entity Type | Individual
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Provider Name | WILLIAM MATTHEW PRIDY B.S.W.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2013
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Last Update Date | 07/28/2013
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Provider Practice Location Address
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Address Line | 4455 E 12TH AVE
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City | DENVER
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State | CO
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Zip | 80220-2415
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Country | US
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Telephone | 303-504-7970
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Fax |
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Provider Business Mailing Address
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Address Line | 8080 W 38TH AVE
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-6114
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Country | US
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Telephone | 720-329-1765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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