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General NPI Number Information
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NPI Number | 1780006676
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Entity Type | Organization
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Legal Business Name | POETRY OF LIFE COUNSELING SERVICES
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 36 SOUTH 18TH AVE D-3
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City | BRIGHTON
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State | CO
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Zip | 80601-4291
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Country | US
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Telephone | 303-880-5270
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Fax | 720-685-8888
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | BRIGHTON
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State | CO
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Zip | 80601-0092
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Country | US
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Telephone | 303-880-5270
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Fax | 720-685-8888
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Authorized Official
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Title or Position | COUNSELOR
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Name | MRS. VALERIE JEAN BYE-WOLFE
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Credential | LPC
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Telephone | 303-880-5270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0006249
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License Number State | CO
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