Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1460 | OR |
N | 175L00000X | Homeopath | 1460 | OR |
NPI | 1316199383 |
---|---|
Provider Name | Dr. Shelese Marie Pratt |
First Address | Louisville, CO 80027-2416 |
Second Address | Louisville, CO 80027-2416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 11/06/2021 |