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NPI Code Detail

MEDICARE: MS. GLENDA LEE ANDRESEN MFT

MEDICARE:  MS. GLENDA LEE ANDRESEN  MFT
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
1106H00000XMarriage & Family Therapist632CO
2106H00000XMarriage & Family Therapist36437CA

General Provider Information

NPI Number : 1144345786
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLENDA LEE ANDRESEN MFT
Provider Business Mailing Address
First Line : 1739 AZALEA DR
Second Line : #4
City : FORT COLLINS
State : CO
Zip : 80526-5747
Country : US
Telephone Number : 970-217-2026
Fax Number :
Provider Business Practice Location Address
First Line : 1739 AZALEA DR
Second Line : #4
City : FORT COLLINS
State : CO
Zip : 80526-5747
Country : US
Telephone Number : 970-217-2026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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Directions to “ MS. GLENDA LEE ANDRESEN MFT” Practice Location

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