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Individual

MS. HEATHER FRANCES BARE AUGST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
311 MAPLETON AVE, BOULDER, CO 80304-3979
(303) 440-2154
Mailing address
1375 N FORD ST, GOLDEN, CO 80403-1349
(858) 405-8402

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2816
CO
174400000X
Specialist
OT3048
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT0030480
BLUE SHIELD ID
CA
Enumeration date
03/24/2006
Last updated
01/21/2010
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