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General NPI Number Information
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NPI Number | 1598510307
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Entity Type | Individual
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Provider Name | KATHLEEN RIVERS CNS, LDN
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Gender | Female
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 4410 ARAPAHOE AVE STE 110
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City | BOULDER
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State | CO
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Zip | 80303-1135
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Country | US
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Telephone | 720-315-0051
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Fax |
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Provider Business Mailing Address
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Address Line | 1348 SNOWBERRY LN
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City | LOUISVILLE
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State | CO
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Zip | 80027-2450
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Country | US
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Telephone | 808-439-9395
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | DX6385
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License Number State | MD
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