Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LPC.0014348 | CO |
N | 103TC1900X | Counseling Psychologist | NLC.0103641 | CO |
NPI | 1013378637 |
---|---|
Provider Name | Kelly Laird-Gillespie |
First Address | Colorado Springs, CO 80920-3736 |
Second Address | Colorado Springs, CO 80920-3736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2016 |
Last Update Date | 25/07/2021 |