Provider Demographics
NPI:1356892178
Name:BARLAU, RONNALEE ANN (CAC II)
Entity type:Individual
Prefix:
First Name:RONNALEE
Middle Name:ANN
Last Name:BARLAU
Suffix:
Gender:F
Credentials:CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 S WADSWORTH BLVD
Mailing Address - Street 2:112
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5415
Mailing Address - Country:US
Mailing Address - Phone:855-384-2656
Mailing Address - Fax:
Practice Address - Street 1:1360 S WADSWORTH BLVD
Practice Address - Street 2:112
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5415
Practice Address - Country:US
Practice Address - Phone:855-384-2656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007591101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)