Individual
MR. JUSTIN GASPER JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC, NCC
Contact information
Practice address
9255 W ALAMEDA AVE STE E, LAKEWOOD, CO 80226-2802
(303) 513-3391
Mailing address
9255 W ALAMEDA AVE STE E, LAKEWOOD, CO 80226-2802
(303) 513-3391
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4761
CO
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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