Individual
MS. KATHARINE FULLER NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1920 EASTLAWN AVE, DURANGO, CO 81301-4833
(970) 757-1868
Mailing address
1920 EASTLAWN AVE, DURANGO, CO 81301-4833
(970) 759-1868
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
952
CO
1041C0700X
Clinical Social Worker
Primary
CSW09923432
CO
Other
Enumeration date
11/03/2011
Last updated
02/26/2014
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