Individual
INGRID RUTA MARY AVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1042 TWIN SISTERS RD, NEDERLAND, CO 80466-9600
(805) 453-8544
Mailing address
2127 16TH ST, BOULDER, CO 80302-4355
(805) 453-8544
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09927715
CO
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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