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General NPI Number Information
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NPI Number | 1215687728
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Entity Type | Individual
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Provider Name | TATUM KIERA SANTACASA MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/27/2022
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Last Update Date | 04/30/2023
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Provider Practice Location Address
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Address Line | 14241 E 4TH AVE STE 5-140
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City | AURORA
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State | CO
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Zip | 80011-8733
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Country | US
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Telephone | 720-843-4405
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Fax |
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Provider Business Mailing Address
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Address Line | 20000 MITCHELL PL UNIT 3
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City | DENVER
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State | CO
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Zip | 80249-7229
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Country | US
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Telephone | 602-920-0216
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0002056
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License Number State | CO
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