Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC.0011929 | CO |
NPI | 1003209891 |
---|---|
Provider Name | Shannon Michelle Paulson |
First Address | Denver, CO 80247-1314 |
Second Address | Westminster, CO 80003-2605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2015 |
Last Update Date | 14/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026237 | KAISER COMMERCIAL NUMBER (01) | CO |
97250252 | (05) | CO |