Individual
SHANA MONIQUE TYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
445 W BERRY AVE, LITTLETON, CO 80120-1601
(303) 412-3840
(303) 412-3357
Mailing address
8501 E ALAMEDA AVE UNIT 1528, DENVER, CO 80230-6048
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CO
101YM0800X
Mental Health Counselor
—
CO
Other
Enumeration date
12/09/2017
Last updated
12/09/2017
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