Provider Demographics
NPI:1275732778
Name:COTTS, NICOLE KIRSTEN
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:KIRSTEN
Last Name:COTTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3161 BOOSHWAY CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-4731
Mailing Address - Country:US
Mailing Address - Phone:970-433-2930
Mailing Address - Fax:
Practice Address - Street 1:3161 BOOSHWAY CT
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-4731
Practice Address - Country:US
Practice Address - Phone:970-433-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor