Provider Demographics
NPI:1922172378
Name:GNANDT, MARY A (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:A
Last Name:GNANDT
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5814 HIGHWAY 348
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-9714
Mailing Address - Country:US
Mailing Address - Phone:970-323-5400
Mailing Address - Fax:970-323-9090
Practice Address - Street 1:5814 HIGHWAY 348
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425-9714
Practice Address - Country:US
Practice Address - Phone:970-323-5400
Practice Address - Fax:970-323-9090
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4230101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional