MEDICARE: CHRISTINA PALMER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1306398920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PALMER LPC

Provider Business Mailing Address
First Line	:	76 WALTHAM AVE
Second Line	:
City	:	MANITOU SPRINGS
State	:	CO
Zip	:	80829-1613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W MIDLAND AVE # 250
Second Line	:
City	:	WOODLAND PARK
State	:	CO
Zip	:	80863-3144
Country	:	US
Telephone Number	:	719-238-5800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2016
Last Update Date	:	10/31/2016

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Directions to “ CHRISTINA PALMER LPC” Practice Location

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