Provider Demographics
NPI:1972281400
Name:KORCHO, MEHARI
Entity Type:Individual
Prefix:
First Name:MEHARI
Middle Name:
Last Name:KORCHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9279 RIFLE ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-7215
Mailing Address - Country:US
Mailing Address - Phone:720-305-3447
Mailing Address - Fax:
Practice Address - Street 1:9279 RIFLE ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-7215
Practice Address - Country:US
Practice Address - Phone:720-305-3447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker