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General NPI Number Information
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NPI Number | 1720326515
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Entity Type | Organization
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Legal Business Name | TATE RECONSTRUCTION SERVICES
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 7500 W MISSISSIPPI AVE SUITE B-160
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City | LAKEWOOD
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State | CO
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Zip | 80226-4550
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Country | US
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Telephone | 303-968-4048
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 771
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City | INDIAN HILLS
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State | CO
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Zip | 80454-0771
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Country | US
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Telephone | 303-968-4048
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Fax | 303-301-8342
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DR. YVONNE B TATE
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Credential | PH.D., LPC, BCN
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Telephone | 303-968-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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