Provider Demographics
NPI:1255618443
Name:BLAU, NATTALIE SWARTZ (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:NATTALIE
Middle Name:SWARTZ
Last Name:BLAU
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6815 COUNTY ROAD 203
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-3727
Mailing Address - Country:US
Mailing Address - Phone:970-779-7404
Mailing Address - Fax:
Practice Address - Street 1:128 W 14TH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5100
Practice Address - Country:US
Practice Address - Phone:970-779-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3056101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional