Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1303 | CO |
NPI | 1003024753 |
---|---|
Provider Name | Craig Mcfadden |
First Address | Fort Collins, CO 80528-9579 |
Second Address | Fort Collins, CO 80528-9579 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |