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General NPI Number Information
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NPI Number | 1376933218
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Entity Type | Individual
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Provider Name | CORY REID-VANAS MA LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 2727 BRYANT ST STE 300
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City | DENVER
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State | CO
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Zip | 80211-4168
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Country | US
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Telephone | 720-252-0345
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Fax |
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Provider Business Mailing Address
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Address Line | 2727 BRYANT ST STE 300
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City | DENVER
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State | CO
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Zip | 80211-4168
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Country | US
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Telephone | 720-252-0345
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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.0001187
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License Number State | CO
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