Individual
GRACE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2305 CANYON BLVD STE 101, BOULDER, CO 80302-5651
(720) 370-6465
Mailing address
2305 CANYON BLVD STE 101, BOULDER, CO 80302-5651
(720) 370-6465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCC.0016965
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/16/2018
Last updated
01/06/2021
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