Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003072513 |
---|---|
Provider Name | Mrs. Stephenie Combs |
First Address | Littleton, CO 80120-1812 |
Second Address | Littleton, CO 80120-5252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 04/08/2008 |