Individual
MR. CHARLES A RISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.,ED.S.,LPC
Contact information
Practice address
2754 COMPASS DR, SUITE 115, GRAND JUNCTION, CO 81506-8714
(970) 245-6525
(970) 245-6574
Mailing address
CO PHROG SERVICES, PO BOX 40704, GRAND JUNCTION, CO 81504
(970) 245-6525
(970) 245-6574
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1312
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081852
—
CO
Enumeration date
11/24/2006
Last updated
07/08/2007
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