Provider Demographics
NPI:1790539773
Name:INTERSECTIONAL FERTILITY
Entity Type:Organization
Organization Name:INTERSECTIONAL FERTILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-BOUCHIER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPL OM
Authorized Official - Phone:303-229-9684
Mailing Address - Street 1:12157 W CEDAR DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2105
Mailing Address - Country:US
Mailing Address - Phone:303-229-9684
Mailing Address - Fax:
Practice Address - Street 1:12157 W CEDAR DR STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2105
Practice Address - Country:US
Practice Address - Phone:303-229-9684
Practice Address - Fax:808-400-7397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty