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General NPI Number Information
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NPI Number | 1336725480
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Entity Type | Individual
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Provider Name | KATTIA BLANCO
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Gender | Female
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 2625 S COLORADO BLVD
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City | DENVER
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State | CO
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Zip | 80222-5910
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Country | US
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Telephone | 720-545-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 1995 E COALTON RD APT 75-106
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City | SUPERIOR
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State | CO
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Zip | 80027-4547
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Country | US
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Telephone | 864-986-8802
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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