Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 3389 | CO |
N | 101YP2500X | Professional Counselor | 3281 | CO |
NPI | 1003876210 |
---|---|
Provider Name | Thalia Ray Andrews |
First Address | Denver, CO 80222-6012 |
Second Address | Denver, CO 80218-1614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |