Individual
MAIRA CONSUELO MAGALLANES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10699 MELODY DR STE 2, NORTHGLENN, CO 80234-4131
(720) 507-3841
Mailing address
428 S PERRY ST, DENVER, CO 80219-2528
(720) 366-5579
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-115-0281
DRIVERS LICEENSE
CO
Enumeration date
01/11/2022
Last updated
01/11/2022
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