Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 104100000X | Social Worker |
NPI | 1215574116 |
---|---|
Provider Name | Anntella Lyn Wells |
First Address | Aurora, CO 80010-2221 |
Second Address | Aurora, CO 80010-2221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2019 |
Last Update Date | 10/12/2019 |