| Out Boulder County | |
|
1443 Spruce St Boulder CO 80302-4814 | |
| (303) 449-5777 | |
| Not Available |
| Full Name | Out Boulder County |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1443 Spruce St, Boulder, Colorado |
| Authorized Official Name and Position | Tamora Tanniehill (MENTAL HEALTH PROGRAM MANAGER) |
| Authorized Official Contact | 3034995777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Out Boulder County Po Box 1018 Boulder CO 80306-1018 Ph: (303) 499-5777 | Out Boulder County 1443 Spruce St Boulder CO 80302-4814 Ph: (303) 449-5777 |
| NPI Number | 1932856069 |
|---|---|
| Provider Enumeration Date | 03/08/2022 |
| Last Update Date | 07/05/2022 |
| Certification Date | 07/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932856069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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