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Individual

MR. CHARLES LENTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LPC

Contact information

Practice address
700 FOURMILE PKWY, CANON CITY, CO 81212-9114
(719) 276-7500
(719) 276-6961
Mailing address
700 FOURMILE PKWY, CANON CITY, CO 81212-9114
(719) 276-7500
(719) 276-6961

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2529
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
72406259
CO
Enumeration date
06/27/2007
Last updated
07/09/2007
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