Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC.0005466 | CO |
NPI | 1003442146 |
---|---|
Provider Name | Patricia Gallegos |
First Address | Centennial, CO 80122-2918 |
Second Address | Centennial, CO 80122-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2020 |
Last Update Date | 20/03/2020 |