Individual
GRACE ELISE KACKSTAETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MFTC
Contact information
Practice address
10190 BANNOCK ST STE 120, NORTHGLENN, CO 80260-6052
(970) 460-8009
Mailing address
830 MT SNEFFELS AVE, SEVERANCE, CO 80550-4888
(801) 708-3673
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MFTC.0014626
CO
Other
Enumeration date
01/11/2022
Last updated
09/25/2024
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