Doctor Name: | CAROLYN TREDINNICK |
NPI Number: | 1154677490 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 910 E Railroad Ave Fort Morgan, CO - 807013399 |
Business Phone Number: | 9705224549 |
Business Fax Number: | 9705224211 |
Mailing Address: | 211 W Main St, STERLING |
State: | CO |
Postal Code: | 807513168 |
Phone Number: | 9705224549 |
Fax Number: | 9705224211 |
NPI Enumeration Date: | 07/24/2012 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |