Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003339938 |
---|---|
Provider Name | Debra Hyatt |
First Address | Colorado Springs, CO 80903-1240 |
Second Address | Colorado Springs, CO 80903-1240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2017 |
Last Update Date | 23/07/2017 |