Individual
JENNIFER LEE WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MA
Contact information
Practice address
919 3RD AVE, MONTE VISTA, CO 81144-1418
(719) 850-1648
Mailing address
919 3RD AVE, PO BOX 166, MONTE VISTA, CO 81144-1418
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4592
CO
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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