Basic Information
| Provider Information | |||||||||
| NPI: | 1114578689 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAUSTER | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | VIRGINIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2705 S GILPIN ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802106313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402272999 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2450 S VINE ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802105264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038713626 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2019 | ||||||||
| LastUpdateDate: | 09/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.