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General NPI Number Information
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NPI Number | 1629428982
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Entity Type | Organization
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Legal Business Name | ZUMAYA
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1143 SANTA FE DR
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City | DENVER
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State | CO
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Zip | 80204-3543
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Country | US
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Telephone | 559-307-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 31481 UPPER BEAR CREEK RD
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City | EVERGREEN
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State | CO
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Zip | 80439-7818
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Country | US
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Telephone | 559-307-1800
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | GLADYS R VILLA
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Credential |
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Telephone | 559-307-1800
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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 | 09924043
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License Number State | CO
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