Provider Demographics
NPI:1639628274
Name:PLUMB, EILEEN AMYLIA
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:AMYLIA
Last Name:PLUMB
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 1:733 E 2ND AVE
Mailing Address - Street 2:APT 302
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4225
Mailing Address - Country:US
Mailing Address - Phone:707-367-7198
Mailing Address - Fax:
Practice Address - Street 1:2450 S VINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5264
Practice Address - Country:US
Practice Address - Phone:303-871-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health