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Provider Information for 1700326881


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YAKITTA RENFROE


Sex: Female

NPI: 1700326881
Last Updated: 2021-06-27
Certification Date: 2021-06-27

Details

NameValue
NPI1700326881
Enumeration Date2017-03-08
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 3210 E WOODMEN RD STE 100
COLORADO SPRINGS, CO 80920-3591
United States

Phone: 609-442-9722 | Fax:719-960-3286
 
Primary Practice Address 3210 E WOODMEN RD STE 110
COLORADO SPRINGS, CO 80920-3591
United States

Phone: 609-442-9722 | Fax:719-960-3286
 
Secondary Practice Address(es)

265 S HARLAN ST
LAKEWOOD, CO 80226-2261
United States

Phone: 720-272-1289 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101Y00000X - Counselor CO0013563