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NPI Code Detail

MEDICARE: KAYLEE A PETERSON SWC

MEDICARE: KAYLEE A PETERSON SWC
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 WorkerCSW.09932638CO

General Provider Information

NPI Number : 1689437063
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEE A PETERSON SWC
Provider Business Mailing Address
First Line : 1905 BLAKE AVE STE 201
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4286
Country : US
Telephone Number : 970-384-6728
Fax Number : 970-947-9226
Provider Business Practice Location Address
First Line : 1905 BLAKE AVE STE 201
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4286
Country : US
Telephone Number : 970-384-6728
Fax Number : 970-947-9226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2024
Last Update Date : 01/12/2026

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Directions to “ KAYLEE A PETERSON SWC” Practice Location

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