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Individual

MS. EVA L TALBOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
115 S PARKSIDE DRIVE, COLORADO SPRINGS, CO 80910
(719) 572-6340
(719) 447-4792
Mailing address
220 RUSKIN DR, COLORADO SPRINGS, CO 80910
(719) 572-6100
(719) 572-6080

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4413
CO
101YM0800X
Mental Health Counselor
Primary
1677
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
128492
CO
05
37907344
CO
Enumeration date
01/04/2007
Last updated
11/24/2010
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