Provider Demographics
NPI:1447581251
Name:CHAVEZ, SABRA FOLLIS (MM, MT-BC)
Entity Type:Individual
Prefix:
First Name:SABRA
Middle Name:FOLLIS
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80522-0697
Mailing Address - Country:US
Mailing Address - Phone:970-492-5544
Mailing Address - Fax:
Practice Address - Street 1:920 GLENWALL DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-6422
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ994039Medicaid