Individual
NICOLE LYNN IZATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
595 SHOSHONE ST, GRAND JUNCTION, CO 81504-5682
(970) 712-8074
Mailing address
595 SHOSHONE ST, GRAND JUNCTION, CO 81504-5682
(970) 712-8074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
CO
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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