Individual
DEBRA VAN DE TAEYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4643E PUUWAI RD, KALAHEO, HI 96741-9331
(720) 236-6418
Mailing address
4643E PUUWAI RD, KALAHEO, HI 96741-9331
(720) 236-6418
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
247
CO
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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