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Individual

BRENDAN MARK HAGGERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
4455 E 12TH AVE, DENVER, CO 80220-2415
(303) 504-6500
Mailing address
4455 E 12TH AVE, DENVER, CO 80220-2415

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW.0009922831
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09928172
CO

Other

Enumeration date
03/04/2020
Last updated
04/05/2022
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