Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003189952 |
---|---|
Provider Name | Kathryn Broyles Daigle |
First Address | Denver, CO 80218-3203 |
Second Address | Denver, CO 80218-3203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2012 |
Last Update Date | 22/02/2012 |