Provider Demographics
NPI:1164549721
Name:COULSON, SANDRA R (BA, COM)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:R
Last Name:COULSON
Suffix:
Gender:F
Credentials:BA, COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S ONEIDA ST
Mailing Address - Street 2:SUITE 335
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2549
Mailing Address - Country:US
Mailing Address - Phone:303-759-2760
Mailing Address - Fax:303-759-2971
Practice Address - Street 1:2121 S ONEIDA ST
Practice Address - Street 2:SUITE 335
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2549
Practice Address - Country:US
Practice Address - Phone:303-759-2760
Practice Address - Fax:303-759-2971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO71-C-8246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other