Provider Demographics
NPI:1245646694
Name:LOVERDE, MARIE (LAC, DIPL OM)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:LOVERDE
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 E ILIFF AVE APT 193
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3487
Mailing Address - Country:US
Mailing Address - Phone:303-907-7071
Mailing Address - Fax:
Practice Address - Street 1:9400 E ILIFF AVE APT 193
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-3487
Practice Address - Country:US
Practice Address - Phone:303-907-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002012171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist