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Individual

ELISA MARY PAMELIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
179 S PARKSIDE DR, COLORADO SPRINGS, CO 80910-3130
(719) 884-3321
Mailing address
412 S NEVADA AVE APT 205, COLORADO SPRINGS, CO 80903-2100
(812) 319-2356

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0014429
CO

Other

Enumeration date
03/23/2018
Last updated
03/23/2018
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