Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6271 | CO |
NPI | 1003134784 |
---|---|
Provider Name | Ms. Kristan L. Carey |
First Address | Edwards, CO 81632-7938 |
Second Address | Edwards, CO 81632-7938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2010 |
Last Update Date | 03/01/2013 |