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General NPI Number Information
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NPI Number | 1730467218
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Entity Type | Individual
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Provider Name | AMY MARIE VESPA LPC, MAC
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Gender | Female
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 620 BRIDGEWATER PL
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City | CARBONDALE
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State | CO
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Zip | 81623-2185
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Country | US
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Telephone | 970-618-6542
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Fax |
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Provider Business Mailing Address
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Address Line | 812 GRAND AVE STE 204
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-3478
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Country | US
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Telephone | 970-618-6542
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Fax | 970-947-0055
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6152
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License Number State | CO
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