Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 0018999 | CO |
N | 225C00000X | Rehabilitation Counselor | 00374123 | CO |
NPI | 1255098653 |
---|---|
Provider Name | Lauren Davis |
First Address | Denver, CO 80231-4153 |
Second Address | Centennial, CO 80112-2309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2021 |
Last Update Date | 19/11/2021 |