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Individual

KIM NOVAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LPC, NCC

Contact information

Practice address
6600 FIRESTONE BLVD, FIRESTONE, CO 80504-6605
(303) 579-6975
Mailing address
PO BOX 314, FIRESTONE, CO 80520-0314
(303) 579-6975

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5810
CO

Other

Enumeration date
12/11/2006
Last updated
09/30/2010
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