Individual
GRETCHEN LEEZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3050 BROADWAY ST, BOULDER, CO 80304-3154
(815) 979-7005
Mailing address
21 4TH AVE, LONGMONT, CO 80501-5609
(815) 979-7005
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000683
CO
101YM0800X
Mental Health Counselor
Primary
LPC.0012825
CO
Other
Enumeration date
03/16/2020
Last updated
03/16/2020
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