Individual
AVA WALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 CHEROKEE ST, DENVER, CO 80204-3632
(303) 436-3500
Mailing address
1155 CHEROKEE ST, DENVER, CO 80204-3632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7121
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164913
—
CO
Enumeration date
06/29/2012
Last updated
06/29/2012
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