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Provider Information for 1659713832


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SARAH WALGENBACH AA, CAC II


Sex: Female

NPI: 1659713832
Last Updated: 2020-11-18
Certification Date: 2020-11-18

Details

NameValue
NPI1659713832
Enumeration Date2013-07-29
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1795 JET WING DR
COLORADO SPRINGS, CO 80916-2332
United States

Phone: | Fax:
 
Primary Practice Address 1795 JET WING DR
COLORADO SPRINGS, CO 80916-2332
United States

Phone: 719-572-6100 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)COACB-7621
Yes 101YP2500X - Counselor - ProfessionalCOLPC.0016658