Individual
IDA GADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20752 E 50TH PL, DENVER, CO 80249-7634
(720) 907-5783
Mailing address
20752 E 50TH PL, DENVER, CO 80249-7634
(720) 907-5783
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CO
101YM0800X
Mental Health Counselor
—
CO
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042360606
—
CO
Enumeration date
01/15/2021
Last updated
01/15/2021
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