Individual
MARY ELLEN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2205 ROCKY MOUNTAIN AVE, UNIT 302, LOVELAND, CO 80538-8843
(253) 394-1054
Mailing address
2205 ROCKY MOUNTAIN AVE, UNIT 302, LOVELAND, CO 80538-8843
(253) 394-1054
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0014899
CO
101Y00000X
Counselor
CG60132886
WA
Other
Enumeration date
11/05/2010
Last updated
04/06/2017
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