Individual
NICOLE CERUTTI YAZDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, R-DMT, LCAT-LP
Contact information
Practice address
1150 MAXWELL AVE STE 200, BOULDER, CO 80304-4185
(800) 261-0127
Mailing address
1150 MAXWELL AVE STE 200, BOULDER, CO 80304-4185
(800) 261-0127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225600000X
Dance Therapist
Primary
R-DMT-2266
—
Other
Enumeration date
09/27/2017
Last updated
03/17/2018
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