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Individual

MARY EMMA FAWCETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MFTC

Contact information

Practice address
12303 AIRPORT WAY STE 125, BROOMFIELD, CO 80021-2729
(970) 310-3406
Mailing address
2950 TENNYSON ST, DENVER, CO 80212-3029
(303) 433-2541

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPCC.0017575
CO
106H00000X
Marriage & Family Therapist
Primary
MFTC.0014311
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LPCC.0017575
CO
Enumeration date
08/10/2020
Last updated
04/09/2025
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