Provider Demographics
NPI:1144308685
Name:SANCHEZ, NEIL KIM
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:KIM
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 VISTA GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1436
Mailing Address - Country:US
Mailing Address - Phone:970-236-8616
Mailing Address - Fax:
Practice Address - Street 1:1006 N 5TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7561
Practice Address - Country:US
Practice Address - Phone:970-579-0003
Practice Address - Fax:970-433-7671
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health