Provider Demographics
NPI:1225330186
Name:WASSERMAN, TUESDAY L (LAC)
Entity Type:Individual
Prefix:
First Name:TUESDAY
Middle Name:L
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:TUESDAY
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:2800 FOLSOM ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3738
Mailing Address - Country:US
Mailing Address - Phone:303-443-3993
Mailing Address - Fax:303-442-4104
Practice Address - Street 1:2800 FOLSOM ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3738
Practice Address - Country:US
Practice Address - Phone:303-443-3993
Practice Address - Fax:303-442-4104
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04673171100000X
WAAC 60172152171100000X
CO2329171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist