MEDICARE: VANESSA ANGELA DENTON M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	14065	CO

General Provider Information

NPI Number	:	1073874350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA ANGELA DENTON M.A.

Provider Business Mailing Address
First Line	:	2821 S PARKER RD
Second Line	:	SUITE 145
City	:	AURORA
State	:	CO
Zip	:	80014-2735
Country	:	US
Telephone Number	:	720-505-3643
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 S PARKER RD
Second Line	:	SUITE 145
City	:	AURORA
State	:	CO
Zip	:	80014-2735
Country	:	US
Telephone Number	:	720-505-3643
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	06/04/2012

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