Individual
ALICE MARIE VIENNEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2101 KEN PRATT BLVD STE 200, LONGMONT, CO 80501-6568
(303) 649-3500
(303) 649-3501
Mailing address
PO BOX 911057, DENVER, CO 80291-1057
(800) 953-0104
(303) 765-6640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
080951-1
NY
1041C0700X
Clinical Social Worker
Primary
CSW.09923379
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65901240
—
CO
Enumeration date
04/16/2014
Last updated
04/16/2019
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