Matthew Jaeckel LCSW

NPI 1649420993 - Social Worker - 1041C0700X

NPI Details
NPI 1649420993
Gender Male
Enumeration Date 09/23/2008
Last Updated 08/13/2012
Entity Type Individual
Active Over 8 years ago
Practice Location
1333 IRIS AVE
BOULDER CO, 80304-2226, US
Phone (303) 443-8500
Fax
Business Location
1333 IRIS AVE
BOULDER CO, 80304-2226, US
Phone
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Colorado
License Number 1066
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According to our database, Matthew Jaeckel LCSW NPI is 1649420993, taxonomy code is 1041C0700X and license number is 1066, license state is located at Colorado. Matthew Jaeckel LCSW physically located at 1333 Iris Ave, Boulder CO, 80304-2226. NPI Number Matthew Jaeckel LCSW has the Individual type.

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1649420993 NPI number is provided on an as is basis without warranty of any kind. 1649420993 is maintained by the National Plan & Provider Enumeration System. The contents of Matthew Jaeckel LCSW are for informational purposes only.