Provider Demographics
NPI:1457775405
Name:ALAM, MUNIRAH NISHAT (MA)
Entity Type:Individual
Prefix:
First Name:MUNIRAH
Middle Name:NISHAT
Last Name:ALAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 48120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-8120
Mailing Address - Country:US
Mailing Address - Phone:303-837-1501
Mailing Address - Fax:303-837-0388
Practice Address - Street 1:2490 W 26TH AVE STE 300A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5321
Practice Address - Country:US
Practice Address - Phone:303-837-1501
Practice Address - Fax:303-837-0388
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0013432101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor