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General NPI Number Information
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NPI Number | 1639977895
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Entity Type | Organization
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Legal Business Name | MUSTARD SEED HEALTH AND WELLBEING
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 2951 E US HIGHWAY 50
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City | CANON CITY
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State | CO
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Zip | 81212-2701
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Country | US
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Telephone | 719-204-3480
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 BLUFF ST
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City | CANON CITY
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State | CO
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Zip | 81212-9422
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Country | US
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Telephone | 719-204-3492
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | PAMELA A SENG
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Credential | LPC
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Telephone | 719-204-3492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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