Provider Demographics
NPI:1649013087
Name:POW, RAYMOND (MS)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:POW
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S PARKER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2163
Mailing Address - Country:US
Mailing Address - Phone:405-612-7621
Mailing Address - Fax:
Practice Address - Street 1:7133 W VIRGINIA AVE APT 208
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3157
Practice Address - Country:US
Practice Address - Phone:405-612-7621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002626106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist