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DIANA FRIES MED, LPCC
School >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1467115485
Individual Registrant: DIANA FRIES MED, LPCC
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
126 E GARLAND ST LA VETA, CO 81055-5075 US
Tel: 402-452-1586 Fax: --
Tel: 402-452-1586 Fax: --
Contact information for business:
PO BOX 822 LA VETA, CO 81055-0822 US
Tel: 402-452-1586 Fax: --
Tel: 402-452-1586 Fax: --
Registration Information:
NPI: 1467115485
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101YS0200X | Behavioral Health & Social Service Providers Counselor School | CO | 265677 |
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor | CO | LPCC.001828 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| DORA | LPCC.0018928 | CO | 01 |
