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Individual

MR. JUSTIN TYLER CLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSW

Contact information

Practice address
4455 E 12TH AVE, DENVER, CO 80220-2415
(303) 504-7700
Mailing address
4455 E 12TH AVE, DENVER, CO 80220-2415

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW.0009925822
CO
106S00000X
Behavior Technician

Other

Enumeration date
12/16/2019
Last updated
03/04/2025
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