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General NPI Number Information
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NPI Number | 1043412422
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Entity Type | Individual
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Provider Name | ELIZABETH L BROTHERS MT, MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 619 MAIN ST SUITE 3C
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-485-3956
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6243
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City | BRECKENRIDGE
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State | CO
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Zip | 80424-6243
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Country | US
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Telephone | 970-485-3956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4620
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License Number State | CO
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