Provider Demographics
NPI:1417677790
Name:KELWAY, CLARE (DIHOM NTP BHCN)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:KELWAY
Suffix:
Gender:F
Credentials:DIHOM NTP BHCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 ARAPAHOE RD # B258
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-6013
Mailing Address - Country:US
Mailing Address - Phone:720-404-0275
Mailing Address - Fax:
Practice Address - Street 1:233 SUNBEAM CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2547
Practice Address - Country:US
Practice Address - Phone:720-404-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach