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Individual

MR. WAYNE LEWIS CARPENTER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MA, PSYCH

Contact information

Practice address
218 PETERSON ST, SUITE A, FORT COLLINS, CO 80524-2986
(970) 224-1778
(970) 472-6590
Mailing address
218 PETERSON ST, SUITE A, FORT COLLINS, CO 80524-2986
(970) 224-1778
(970) 472-6590

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
015
CO

Other

Enumeration date
03/18/2006
Last updated
07/08/2007
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