Provider Demographics
NPI:1922806603
Name:MORADO, AUDREA
Entity type:Individual
Prefix:
First Name:AUDREA
Middle Name:
Last Name:MORADO
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 1:7591 LITTLE FOX LN APT 504
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80549-1995
Mailing Address - Country:US
Mailing Address - Phone:720-505-7448
Mailing Address - Fax:
Practice Address - Street 1:8025 1ST ST # A
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80549-5016
Practice Address - Country:US
Practice Address - Phone:720-505-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO374J00000X
COMT.0020623225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula