Provider Demographics
NPI:1518712132
Name:JANDOVA LUCIER, MARIANA
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:
Last Name:JANDOVA LUCIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3432
Mailing Address - Country:US
Mailing Address - Phone:970-433-5199
Mailing Address - Fax:
Practice Address - Street 1:850 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3432
Practice Address - Country:US
Practice Address - Phone:970-433-5199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical