Basic Information
| Provider Information | |||||||||
| NPI: | 1669704946 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AARDSMA | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | RICHARD | ||||||||
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| Credential: | M.A. LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 BARNES AVE | ||||||||
| Address2: | |||||||||
| City: | LA JUNTA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810502138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193845446 | ||||||||
| FaxNumber: | 7193845672 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 BARNES AVE. | ||||||||
| Address2: | WELLNESS WORKS | ||||||||
| City: | LA JUNTA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193830701 | ||||||||
| FaxNumber: | 7193845672 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2010 | ||||||||
| LastUpdateDate: | 02/11/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | LPC-3523 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.