Basic Information
Provider Information
NPI: 1326374364
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GABOR
FirstName: ANDREW
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1405 FEDERAL BLVD
Address2:  
City: DENVER
State: CO
PostalCode: 802042211
CountryCode: US
TelephoneNumber: 3035041500
FaxNumber: 3038251711
Practice Location
Address1: 1405 FEDERAL BLVD
Address2:  
City: DENVER
State: CO
PostalCode: 802042211
CountryCode: US
TelephoneNumber: 3035041500
FaxNumber: 3038251711
Other Information
ProviderEnumerationDate: 10/27/2009
LastUpdateDate: 10/27/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X10817COY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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