Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC.0016672 | CO |
NPI | 1003330309 |
---|---|
Provider Name | Luis Kashdaro Luna |
First Address | Lakewood, CO 80228-3846 |
Second Address | Lakewood, CO 80228-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2017 |
Last Update Date | 16/11/2020 |