Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ACB.0008071 | CO |
Y | 1041C0700X | Clinical Social Worker | CSW.09923228 | CO |
NPI | 1003222670 |
---|---|
Provider Name | Andrea E Strayer |
First Address | Fort Collins, CO 80525-5540 |
Second Address | Loveland, CO 80537-4461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2014 |
Last Update Date | 31/05/2019 |