Provider Demographics
NPI:1578126264
Name:SCHLOSSER, LENORA RAE
Entity Type:Individual
Prefix:
First Name:LENORA
Middle Name:RAE
Last Name:SCHLOSSER
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 1:2653 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2459
Mailing Address - Country:US
Mailing Address - Phone:303-669-1505
Mailing Address - Fax:
Practice Address - Street 1:2653 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2459
Practice Address - Country:US
Practice Address - Phone:303-669-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical