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General NPI Number Information
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NPI Number | 1972775732
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Entity Type | Individual
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Provider Name | TAMARA LEE BOYER
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Gender | Female
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 2627 REDWING RD STE 220
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City | FORT COLLINS
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State | CO
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Zip | 80526-6331
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Country | US
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Telephone | 970-449-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 4470 S LEMAY AVE APT 323
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City | FORT COLLINS
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State | CO
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Zip | 80525-4821
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Country | US
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Telephone | 970-449-3431
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW 2092
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License Number State | CO
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