Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 0004006 | CO |
NPI | 1063762854 |
---|---|
Provider Name | Dr. Cassie V Comeau |
First Address | Silverthorne, CO 80498-2296 |
Second Address | Breckenridge, CO 80424-6174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 23/02/2015 |