Provider Demographics
NPI:1649479262
Name:NEELY, ERIN ELISE (BA)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ELISE
Last Name:NEELY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CHIPETA AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2736
Mailing Address - Country:US
Mailing Address - Phone:970-210-0808
Mailing Address - Fax:
Practice Address - Street 1:610 CHIPETA AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2736
Practice Address - Country:US
Practice Address - Phone:970-210-0808
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