Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0012970 | CO |
NPI | 1003269879 |
---|---|
Provider Name | Susan Torres |
First Address | Colorado Springs, CO 80917-4907 |
Second Address | Colorado Springs, CO 80917-4907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2016 |
Last Update Date | 18/07/2016 |