Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 992468 | CO |
NPI | 1003118993 |
---|---|
Provider Name | Claudette M Hertner |
First Address | Wheat Ridge, CO 80033-6019 |
Second Address | Wheat Ridge, CO 80033-6019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2010 |
Last Update Date | 26/11/2010 |