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Individual
MARISSA LEIGH VANDOVER
Active
Individual
MARISSA LEIGH VANDOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0011471
CO
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08422389
—
CO
Enumeration date
07/22/2010
Last updated
02/24/2015
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