Doctor Name: | ROBERT B. WENZEL |
NPI Number: | 1003092727 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. LPC |
License Number: | 3204 |
Business Practice Address: | 4360 Montebello Dr Ste 400 Colorado Springs, CO - 809187224 |
Business Phone Number: | 7195939228 |
Business Fax Number: | 7195981705 |
Mailing Address: | 4360 Montebello Dr Ste 400, COLORADO SPRINGS |
State: | CO |
Postal Code: | 809187224 |
Phone Number: | 7195939228 |
Fax Number: | 7195981705 |
NPI Enumeration Date: | 01/11/2008 |
NPI Last Update Date: | 12/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |