Individual
KATHLEEN DEHERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11027 S PIKES PEAK DR, PARKER, CO 80138-7356
(330) 807-4509
Mailing address
22287 MULHOLLAND HWY, #136, CALABASAS, CA 91302-5157
(330) 807-4509
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0000138
CO
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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