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Individual

STORMY MESA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5600 W DARTMOUTH AVE UNIT 104, DENVER, CO 80227-5500
(720) 201-0033
Mailing address
5600 W DARTMOUTH AVE UNIT 104, DENVER, CO 80227-5500
(720) 201-0033

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0011556
CO
225700000X
Massage Therapist
Primary
0019181
CO

Other

Enumeration date
08/22/2014
Last updated
01/14/2019
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