Individual
LORELEI BALDERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Mailing address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0008224
CO
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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