Provider Demographics
NPI:1346999612
Name:TSE, YUKIT
Entity Type:Individual
Prefix:
First Name:YUKIT
Middle Name:
Last Name:TSE
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 1:2707 VALMONT RD APT 306D
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2998
Mailing Address - Country:US
Mailing Address - Phone:720-326-5934
Mailing Address - Fax:
Practice Address - Street 1:2707 VALMONT RD APT 306D
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2998
Practice Address - Country:US
Practice Address - Phone:720-326-5934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018359101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPCC.0018359OtherDORA