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General NPI Number Information
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NPI Number | 1225894991
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Entity Type | Organization
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Legal Business Name | MJL PROFESSIONAL SERVICES, INC.
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 8471 TURNPIKE DR STE 205
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City | WESTMINSTER
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State | CO
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Zip | 80031-7050
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Country | US
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Telephone | 303-875-6207
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20944
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City | BOULDER
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State | CO
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Zip | 80308
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Country | US
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Telephone | 720-602-7972
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Fax | 303-530-1338
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | JULIE KINTZING
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Credential | LCSW
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Telephone | 303-875-6207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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