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Individual

LAUREN ALEXANDRA WALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1790 30TH ST STE 350, BOULDER, CO 80301-1071
(720) 585-3271
Mailing address
451 THISTLE PL, LONGMONT, CO 80504-3907
(303) 809-1371
(303) 420-8831

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW.0009923130
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09929799
CO

Other

Enumeration date
06/23/2014
Last updated
10/03/2024
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