Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0017508 | CO |
NPI | 1003570383 |
---|---|
Provider Name | Genaro Manuel Laynes |
First Address | Firestone, CO 80504-5506 |
Second Address | Denver, CO 80231-2163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2021 |
Last Update Date | 24/10/2021 |