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General NPI Number Information
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NPI Number | 1285484147
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Entity Type | Individual
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Provider Name | KENDALL BAKER RYNO
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Gender | Female
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 5760 W 120TH AVE
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City | BROOMFIELD
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State | CO
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Zip | 80020-6942
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Country | US
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Telephone | 720-810-2355
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Fax |
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Provider Business Mailing Address
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Address Line | 2723 W 167TH PL
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City | BROOMFIELD
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State | CO
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Zip | 80023-9082
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Country | US
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Telephone | 720-470-6685
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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 | LSW.000925074
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License Number State | CO
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