Provider Demographics
NPI:1467002048
Name:WANG, MARIE (BSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:DION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:456 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:456 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5126
Practice Address - Country:US
Practice Address - Phone:303-504-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker