Individual
SUSAN KANEMASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACIII
Contact information
Practice address
850 23RD AVE, UNIT A, LONGMONT, CO 80501-1114
(303) 245-0123
Mailing address
912 W MOUNTAIN AVE, FORT COLLINS, CO 80521-2510
(303) 968-4084
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC0020836
CO
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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