Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0011895 | CO |
NPI | 1003221284 |
---|---|
Provider Name | Christia Young |
First Address | Denver, CO 80235-2997 |
Second Address | Westminster, CO 80021-3918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2014 |
Last Update Date | 14/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
48434035 | (05) | CO |