Healthcare Provider Details

I. General information

NPI: 1639861065
Provider Name (Legal Business Name): EMILY GRACE OLMEDO-DANIEL M.ED, ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 E WOODMEN RD STE 200
COLORADO SPRINGS CO
80920-3586
US

IV. Provider business mailing address

8291 HENZLEE PL
FALCON CO
80831-7279
US

V. Phone/Fax

Practice location:
  • Phone: 719-445-6744
  • Fax: 719-960-3135
Mailing address:
  • Phone: 336-823-7385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0024565
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: