Most Relevant Information
Provider Data
| NPI Number: | 1003567041 |
| Provider Name: | GRACE ELISE KACKSTAETTER MA, MFTC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MFTC.0014626 |
Most Important Dates
| Enumeration Date: | 01/11/2022 |
| Last Updated: | 09/25/2024 |
Provider Practice Location
10190 BANNOCK ST STE 120
NORTHGLENN
CO
802606052
Practice Location Phone/Fax
| Phone: | 9704608009 |
| Fax: |
Provider Mailing Location
830 MT SNEFFELS AVE
SEVERANCE
CO
805504888
Provider Mailing Phone/Fax
| Phone: | 8017083673 |
| Fax: |