Individual
FREIA I HOOPER-BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
395 CRESTVIEW DR, WETMORE, CO 81253-0025
(719) 784-3838
(719) 784-3838
Mailing address
PO BOX 25, WETMORE, CO 81253-0025
(719) 784-3838
(719) 784-3838
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1478
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076813
—
CO
Enumeration date
01/08/2007
Last updated
07/09/2007
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