MEDICARE: MS. MARIE ELAINE FELDHAUS N/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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1235323700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIE ELAINE FELDHAUS N/A

Provider Business Mailing Address
First Line	:	4851 INDEPENDENCE ST
Second Line	:	SUITE 200
City	:	WHEAT RIDGE
State	:	CO
Zip	:	80033-6715
Country	:	US
Telephone Number	:	303-425-0300
Fax Number	:	303-432-5071

Provider Business Practice Location Address
First Line	:	1675 CARR ST
Second Line	:	SUITE 215N
City	:	LAKEWOOD
State	:	CO
Zip	:	80214-5939
Country	:	US
Telephone Number	:	303-432-5700
Fax Number	:	303-432-5790

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

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	08/28/2007

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