Provider Information for 1851439129
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LORI G. MOSES-BENNETT LCSW
Sex: Female
NPI: 1851439129
Last Updated: 2007-08-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1851439129 | ||||||||
| Enumeration Date | 2007-02-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 4174 BOULDER, CO 80306-4174 United States Phone: 303-709-7601 | Fax:303-665-5501 | ||||||||
| Primary Practice Address | 1634 WALNUT ST SUITE 201 BOULDER, CO 80302-5400 United States Phone: 303-709-7601 | Fax:303-665-5501 | ||||||||
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