Provider Demographics
NPI:1215348586
Name:BARTRAN, GWEN (MI)
Entity type:Individual
Prefix:
First Name:GWEN
Middle Name:
Last Name:BARTRAN
Suffix:
Gender:F
Credentials:MI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 29TH ST STE 270
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2770
Mailing Address - Country:US
Mailing Address - Phone:970-988-6978
Mailing Address - Fax:
Practice Address - Street 1:150 E 29TH ST STE 270
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2770
Practice Address - Country:US
Practice Address - Phone:970-988-6978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst