Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | NLC.0105806 | CO |
N | 101YP1600X | Pastoral Counselor | NLC.0105806 | CO |
NPI | 1154937605 |
---|---|
Provider Name | Tania Alexis Fendel |
First Address | Denver, CO 80246-1451 |
Second Address | Denver, CO 80246-1451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2020 |
Last Update Date | 21/09/2020 |