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1902287808
WALLIS MARLEN LUIS
AURORA, CO
NPI
1902287808
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO ACD.0000981)
Enumeration Date
2015-06-16
Last Update Date
2019-10-09
Business Address
WALLIS MARLEN LUIS MFTC
12101 E 2ND AVE STE 100
AURORA, CO 80011-8328
Phone number: 720-810-4063
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Mailing Address
WALLIS MARLEN LUIS MFTC
1427 ROYAL TROON DR
CASTLE ROCK, CO 80104-5245
Phone number: 786-417-5379
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