Individual provider · Type 1 NPI
Charlie Eliza Boutillette, LPC MA
Mental Health Counselor · Alamosa, CO
NPI number
1508990086
Active
Practice location
200 Ross Ave
Alamosa, CO 81101-2451
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 1725 (CO) |
Mental Health Counselor: Definition to come...
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About NPI 1508990086
Charlie Eliza Boutillette, LPC MA's National Provider Identifier is 1508990086, issued on Mar 15, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Alamosa, CO. The record was last updated on Sep 18, 2024.