Provider Demographics
NPI:1043478019
Name:EPEN, VIRGINIA JEAN
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:JEAN
Last Name:EPEN
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 1:5213 S IRONTON WAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3822
Mailing Address - Country:US
Mailing Address - Phone:303-250-5977
Mailing Address - Fax:866-699-7249
Practice Address - Street 1:5213 S IRONTON WAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-3822
Practice Address - Country:US
Practice Address - Phone:303-250-5977
Practice Address - Fax:866-699-7249
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional