Provider Demographics
NPI:1861211435
Name:HARTSON, CONNOR JAMES
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:JAMES
Last Name:HARTSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 S BROADWAY APT 349
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-1984
Mailing Address - Country:US
Mailing Address - Phone:720-448-0046
Mailing Address - Fax:
Practice Address - Street 1:2111 S DAHLIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5105
Practice Address - Country:US
Practice Address - Phone:720-206-9644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician