Provider Demographics
NPI:1215107586
Name:WROTEN, CAROLYN ROBERTA
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ROBERTA
Last Name:WROTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CAROLYN
Other - Middle Name:ROBERTA
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8158 SILVER GLEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817
Mailing Address - Country:US
Mailing Address - Phone:719-382-8467
Mailing Address - Fax:
Practice Address - Street 1:8158 SILVER GLEN DRIVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-4017
Practice Address - Country:US
Practice Address - Phone:719-382-8467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor