Individual
CARISSA ROSE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
9808 W CEDAR AVE, LAKEWOOD, CO 80226
(303) 432-5400
(303) 432-5442
Mailing address
4851 INDEPENDENCE STREET, SUITE 200, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
(303) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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