Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ACA.0007789 | CO |
NPI | 1003472002 |
---|---|
Provider Name | Morgan R Gutrich |
First Address | Fort Collins, CO 80525-5540 |
Second Address | Loveland, CO 80537-4461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 15/05/2019 |