=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548741119
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY ROWLAND PHD, LSW, MDIV
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2018
-----------------------------------------------------
Last Update Date | 08/22/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6565 E COLORADO DR
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80224-2201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-400-7234
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6565 E COLORADO DR
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80224-2201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-400-7234
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 0009922056
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------