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General NPI Number Information
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NPI Number | 1215337043
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Entity Type | Organization
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Legal Business Name | KLM THERAPY LLC
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 39852 SWIFT CREEK CIR
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City | ELIZABETH
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State | CO
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Zip | 80107-9408
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Country | US
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Telephone | 720-933-8294
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Fax | 303-646-8479
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Provider Business Mailing Address
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Address Line | 29888 RAWHIDE CT
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City | ELIZABETH
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State | CO
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Zip | 80107-6605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER / CHILD AND FAMILY COUNSELOR
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Name | MRS. KATHERINE LILLIAN MAGILL
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Credential | MA, LPC
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Telephone | 720-933-8294
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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 | 3481
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License Number State | CO
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