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General NPI Number Information
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NPI Number | 1629394283
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Entity Type | Organization
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Legal Business Name | DEVARIA CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 5429 S ESPANA CT
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City | CENTENNIAL
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State | CO
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Zip | 80015-3707
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Country | US
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Telephone | 303-956-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 5429 S ESPANA CT
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City | CENTENNIAL
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State | CO
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Zip | 80015-3707
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Country | US
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Telephone | 303-956-6644
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. MYRNA D. ALLEN
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Credential | LCSW
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Telephone | 303-956-6644
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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 | 991205
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License Number State | CO
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