MEDICARE: ROSE M ALLEN

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	104100000X	Social Worker	CSW991536	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649289661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE M ALLEN

Provider Business Mailing Address
First Line	:	DEPT 1057
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80291-1057
Country	:	US
Telephone Number	:	303-486-5504
Fax Number	:	303-486-5501

Provider Business Practice Location Address
First Line	:	4231 W 16TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80291-1057
Country	:	US
Telephone Number	:	303-629-2333
Fax Number	:	303-595-2662

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/08/2007

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Directions to “ ROSE M ALLEN ” Practice Location

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