Individual
MS. VIRGINIA MARIE DETWEILER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW CAC III
Contact information
Practice address
2300 CANYON BLVD, BOUDLER, CO 80302
(303) 442-0883
(303) 442-0883
Mailing address
1517 48TH ST, BOULDER, CO 80303
(303) 442-0883
(303) 442-7122
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW991908
CO
Other
Enumeration date
04/26/2006
Last updated
07/08/2007
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