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General NPI Number Information
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NPI Number | 1437456746
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Entity Type | Individual
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Provider Name | LYDIA CAMIELL GAREY PN-25642, ACC-6941
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Gender | Female
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1620 GAYLORD ST
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City | DENVER
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State | CO
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Zip | 80206-1207
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Country | US
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Telephone | 303-388-5894
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Fax | 303-336-1601
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Provider Business Mailing Address
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Address Line | 14005 E 54TH AVE
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City | DENVER
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State | CO
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Zip | 80239-4109
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Country | US
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Telephone | 303-204-3293
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACC-6941
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN-25642
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License Number State | CO
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