Individual
MICHELLE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAC
Contact information
Practice address
701 S 9TH ST, CANON CITY, CO 81212-4911
(719) 275-2351
Mailing address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2589
CO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/23/2016
Last updated
09/24/2024
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