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NPI Code Detail

MEDICARE: SHAUNA LEE GROVES

MEDICARE: SHAUNA LEE GROVES
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1366602823
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUNA LEE GROVES
Provider Business Mailing Address
First Line : 214 VIVIAN ST
Second Line :
City : LONGMONT
State : CO
Zip : 80501-4839
Country : US
Telephone Number : 760-963-4101
Fax Number :
Provider Business Practice Location Address
First Line : 1650 38TH ST STE 100E
Second Line :
City : BOULDER
State : CO
Zip : 80301-2624
Country : US
Telephone Number : 530-891-2775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2008
Last Update Date : 09/27/2024

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Directions to “ SHAUNA LEE GROVES ” Practice Location

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