Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ACA 6954 | CO |
NPI | 1003240052 |
---|---|
Provider Name | Jamie Lynn Contreraz |
First Address | Thornton, CO 80260-4912 |
Second Address | Thornton, CO 80260-4912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2013 |
Last Update Date | 27/08/2013 |