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General NPI Number Information
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NPI Number | 1568351120
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Entity Type | Organization
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Legal Business Name | WINGS OF CHANGE LLC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1150 GALAPAGO ST APT 222
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City | DENVER
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State | CO
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Zip | 80204-3576
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Country | US
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Telephone | 720-819-6923
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 SHERMAN STREET STE 200 #2198
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City | DENVER
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State | CO
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Zip | 80203
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Country | US
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Telephone | 720-819-6923
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | LYNETTE MARIE GARBER
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Credential | MSW, LCSW
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Telephone | 720-819-6923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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