Individual
MARYANNE AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CAC III
Contact information
Practice address
1432 GRAND AVE, GLENWOOD SPRINGS, CO 81601-3808
(172) 039-4986
Mailing address
PO BOX 4091, FRISCO, CO 80443-4091
(720) 394-9869
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0020794
CO
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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