Basic Information
| Provider Information | |||||||||
| NPI: | 1093153520 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HRABAL | ||||||||
| FirstName: | JENNALEE | ||||||||
| MiddleName: | WOLF | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2744 BRUCHEZ PKWY UNIT 104 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802341901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132774217 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8407 BRYANT ST | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800313809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034877776 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2013 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 66445 | TX | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 15350 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.