Healthcare Provider Details
I. General information
NPI: 1043365745
Provider Name (Legal Business Name): KIRSTEN LYNN WULFSBERG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2465 SOUTH DOWNING ST SUITE 110
DENVER CA
80210
US
IV. Provider business mailing address
2465 SOUTH DOWNING ST SUITE 110
DENVER CA
80210
US
V. Phone/Fax
- Phone: 303-778-5774
- Fax: 303-778-2436
- Phone: 303-778-5774
- Fax: 303-778-2436
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 2943 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: