Doctor Name: | MRS. VIANN MCCULLION POWERS |
NPI Number: | 1518929330 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, LMFT |
License Number: | 1389 |
Business Practice Address: | 2 North Parkway Colorado City, CO - 81019 |
Business Phone Number: | 7192892758 |
Business Fax Number: | 7194892758 |
Mailing Address: | 10805 Decker Circle, RYE |
State: | CO |
Postal Code: | 81069 |
Phone Number: | 7192480913 |
Fax Number: | 7194892750 |
NPI Enumeration Date: | 04/05/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1389 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |