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General NPI Number Information
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NPI Number | 1952757908
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Entity Type | Individual
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Provider Name | CHANTEL B LANDEROS LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 2526 PATTERSON RD UNIT 200
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1146
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Country | US
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Telephone | 970-812-1292
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Fax |
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Provider Business Mailing Address
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Address Line | 715 HORIZON DR STE 225
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City | GRAND JUNCTION
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State | CO
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Zip | 81506-8743
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0002042
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License Number State | CO
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