Provider Demographics
NPI:1922252402
Name:DI GIORGIO, MARIA GRAZIA (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIA GRAZIA
Middle Name:
Last Name:DI GIORGIO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 30TH ST
Mailing Address - Street 2:#2B
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1351
Mailing Address - Country:US
Mailing Address - Phone:303-544-0889
Mailing Address - Fax:
Practice Address - Street 1:2769 IRIS AVE
Practice Address - Street 2:SUITE #103
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-4405
Practice Address - Country:US
Practice Address - Phone:303-544-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC 4102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health