Individual
TONI LAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
142 6TH ST UNIT 2, FREDERICK, CO 80530-5004
(130) 383-3084
Mailing address
PO BOX 718, FIRESTONE, CO 80520
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/14/2016
Last updated
12/12/2020
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