Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP2500X | Professional Counselor | 7095 | NC |
NPI | 1003176967 |
---|---|
Provider Name | Mrs. Corrie Elisabeth Sias |
First Address | Colorado Springs, CO 80927-4040 |
Second Address | Colorado Springs, CO 80927-4040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2012 |
Last Update Date | 14/02/2020 |