MEDICARE: ELIZABETH BOJANOWSKI

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1851858245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BOJANOWSKI

Provider Business Mailing Address
First Line	:	2181 S TRENTON WAY APT 16-305
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-5392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2370 W ALAMEDA AVE UNIT 8
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-1991
Country	:	US
Telephone Number	:	303-477-8280
Fax Number	:

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

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	02/21/2019

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