Provider Demographics
NPI:1417030842
Name:VESELAK, CHRISTINA T (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:T
Last Name:VESELAK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 ROSLYN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3148
Mailing Address - Country:US
Mailing Address - Phone:303-888-9617
Mailing Address - Fax:303-337-5087
Practice Address - Street 1:1450 S HAVANA ST
Practice Address - Street 2:#712
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4018
Practice Address - Country:US
Practice Address - Phone:303-888-9617
Practice Address - Fax:303-337-5087
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO464106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist