Individual
TAYVON MICHELE SHAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14195 MONTVIEW BLVD, APT 14, AURORA, CO 80011-4289
(303) 748-7049
Mailing address
14195 MONTVIEW BLVD APT 14, AURORA, CO 80011-4274
(303) 748-7049
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
091630512
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412168284
KAISER PERMANENTE
CO
Enumeration date
05/02/2016
Last updated
05/02/2016
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