Individual
MRS. GILLIAN KENNY WILSCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1333 IRIS AVE, BOULDER, CO 80304-2226
(303) 443-8500
Mailing address
1333 IRIS AVE, BOULDER, CO 80304-2226
(303) 443-8500
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1112
CO
106H00000X
Marriage & Family Therapist
1358
NC
Other
Enumeration date
02/12/2007
Last updated
10/13/2014
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