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Individual

MR. GERRY THREATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHC LH 61288295

Contact information

Practice address
15 GRANT ST, PENROSE, CO 81240-9643
(785) 375-2608
Mailing address
15 GRANT ST, PENROSE, CO 81240-9643
(785) 375-2608

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH61288295
WA

Other

Enumeration date
06/09/2020
Last updated
06/26/2024
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