Provider Demographics
NPI:1649499419
Name:BERTRAND-LOVATO, DENISE MARIE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:BERTRAND-LOVATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 SAN MARCO DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-4164
Mailing Address - Country:US
Mailing Address - Phone:303-651-6646
Mailing Address - Fax:
Practice Address - Street 1:529 COFFMAN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5450
Practice Address - Country:US
Practice Address - Phone:303-245-4479
Practice Address - Fax:303-245-4459
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health