Individual
LISA KOETS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1446 HOVER ST STE 205, LONGMONT, CO 80501-2485
(303) 717-8820
Mailing address
1446 HOVER ST STE 205, LONGMONT, CO 80501-2485
(303) 717-8820
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0105971
CO
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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