Individual
MICHAEL GAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
630 2ND AVE, LYONS, CO 80540-5065
(404) 805-2219
Mailing address
PO BOX 1762, LYONS, CO 80540-1762
(404) 805-2219
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
NLC.0107582
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NLC.0107582
LICENSE NUMBER
CO
Enumeration date
07/08/2020
Last updated
07/08/2020
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