MEDICARE: GRETCHEN KAHRE-HOLLAND MA, 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	1092	CO

General Provider Information

NPI Number	:	1811386154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRETCHEN KAHRE-HOLLAND MA, LPC

Provider Business Mailing Address
First Line	:	PO BOX 1261
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-1261
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2769 IRIS AVE
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-4405
Country	:	US
Telephone Number	:	303-818-8357
Fax Number	:

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

Provider Enumeration Date	:	01/09/2015
Last Update Date	:	01/09/2015

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