Provider Demographics
NPI:1528047990
Name:LEVRERO, GARI ASTRUD (MS)
Entity type:Individual
Prefix:MRS
First Name:GARI
Middle Name:ASTRUD
Last Name:LEVRERO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1194 W ASH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4651
Mailing Address - Country:US
Mailing Address - Phone:970-674-3446
Mailing Address - Fax:970-674-3448
Practice Address - Street 1:1194 W ASH ST
Practice Address - Street 2:SUITE C
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4651
Practice Address - Country:US
Practice Address - Phone:970-674-3446
Practice Address - Fax:970-674-3448
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1230231H00000X
AZDA0030231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY1230OtherFLORIDA LICENSE
AZDA0030OtherARIXONA LICENSE