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Individual

GWENDALINE DANIELLE THOREAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., L.P.C., C.A.C.

Contact information

Practice address
1333 IRIS AVE, BOULDER, CO 80304-2226
(303) 443-0850
Mailing address
1333 IRIS AVE, BOULDER, CO 80304-2226
(303) 443-8500

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5880
CO
101YP2500X
Professional Counselor
Primary
3210
CO

Other

Enumeration date
02/01/2012
Last updated
03/09/2015
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