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General NPI Number Information
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NPI Number | 1487263943
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Entity Type | Organization
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Legal Business Name | MILI SHOEMAKER, LLC
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 409 MAIN ST STE 220F
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City | FRISCO
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State | CO
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Zip | 80443-5929
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Country | US
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Telephone | 970-409-0899
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Fax |
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Provider Business Mailing Address
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Address Line | 613 VAIL CIR
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City | DILLON
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State | CO
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Zip | 80435-8312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESIONAL COUNSELOR
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Name | MILAGROS SARMIENTO-SHOEMAKER
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Credential | LPC, RPT-S
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Telephone | 970-409-0899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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