Individual provider · Type 1 NPI

Carissa Rose Waller, BA

Mental Health Counselor · Lakewood, CO

NPI number 1306067467 Active

Practice location

9808 W Cedar Ave
Lakewood, CO 80226

Fax (303) 432-5442

Mailing address

4851 Independence Street, Suite 200
Wheat Ridge, CO 80033-6715

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1306067467

Carissa Rose Waller, BA's National Provider Identifier is 1306067467, issued on May 2, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lakewood, CO. The record was last updated on Jul 8, 2007.