Individual
MRS. ELEANOR LACY BRUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
360 PEAK ONE DRIVE, SUITE 260, FRISCO, CO 80443
(303) 902-9362
Mailing address
2381 S ASH ST, DENVER, CO 80222-6004
(303) 902-9362
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09923651
CO
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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