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General NPI Number Information
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NPI Number | 1871990382
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Entity Type | Individual
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Provider Name | LAURA BURT BA
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Gender | Female
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 7009 S POTOMAC ST SUITE 102
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City | CENTENNIAL
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State | CO
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Zip | 80112-4037
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Country | US
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Telephone | 720-441-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 995 CORONA ST APT. 11
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City | DENVER
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State | CO
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Zip | 80218-2921
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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 |
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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 | NLCO.104780BY
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License Number State | CO
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