Provider Demographics
NPI:1790804029
Name:HEBERT, ELIZABETH KAY (L AC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KAY
Last Name:HEBERT
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4013
Mailing Address - Country:US
Mailing Address - Phone:303-726-3504
Mailing Address - Fax:303-722-4115
Practice Address - Street 1:123 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4013
Practice Address - Country:US
Practice Address - Phone:303-726-3504
Practice Address - Fax:303-722-4115
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1021171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist