Healthcare Provider Details

I. General information

NPI: 1093153520
Provider Name (Legal Business Name): JENNALEE WOLF HRABAL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8407 BRYANT ST
WESTMINSTER CO
80031-3809
US

IV. Provider business mailing address

2744 BRUCHEZ PKWY UNIT 104
WESTMINSTER CO
80234-1901
US

V. Phone/Fax

Practice location:
  • Phone: 303-487-7776
  • Fax:
Mailing address:
  • Phone: 713-277-4217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number66445
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15350
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: