Provider Demographics
NPI:1114713195
Name:GIEHM, MADISON KAY
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:KAY
Last Name:GIEHM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 WATERFALL ST
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-4445
Mailing Address - Country:US
Mailing Address - Phone:970-237-1763
Mailing Address - Fax:
Practice Address - Street 1:1320 WATERFALL ST
Practice Address - Street 2:
Practice Address - City:TIMNATH
Practice Address - State:CO
Practice Address - Zip Code:80547-4445
Practice Address - Country:US
Practice Address - Phone:970-237-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health