Boundless Potential, Llc | |
926 Square Dance Ln Fountain CO 80817-4160 | |
(325) 338-6182 | |
Not Available |
Full Name | Boundless Potential, Llc |
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Speciality | Behavior Analyst |
Location | 926 Square Dance Ln, Fountain, Colorado |
Authorized Official Name and Position | Tiffany Rose Menzel (OWNER) |
Authorized Official Contact | 3253386182 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Boundless Potential, Llc 926 Square Dance Ln Fountain CO 80817-4160 Ph: (325) 338-6182 | Boundless Potential, Llc 926 Square Dance Ln Fountain CO 80817-4160 Ph: (325) 338-6182 |
NPI Number | 1487043980 |
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Provider Enumeration Date | 01/21/2015 |
Last Update Date | 01/21/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487043980 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | 11416922 (* (Not Available)) | Primary |
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