Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | ||
Y | 101YP2500X | Professional Counselor | LPCC.0017177 | CO |
NPI | 1003449620 |
---|---|
Provider Name | Dianna Jean Lawyer-Brook |
First Address | Lyons, CO 80540-8219 |
Second Address | Lyons, CO 80540-8219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2020 |
Last Update Date | 21/02/2020 |