Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 0012218 | CO |
NPI | 1104223239 |
---|---|
Provider Name | Jamie Smalley |
First Address | Louisville, CO 80027-1230 |
Second Address | Boulder, CO 80304-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2014 |
Last Update Date | 04/12/2014 |