| Revision Counseling | |
|
2625 Redwing Rd Fort Collins CO 80526-6313 | |
| (405) 410-6378 | |
| Not Available |
| Full Name | Revision Counseling |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2625 Redwing Rd, Fort Collins, Colorado |
| Authorized Official Name and Position | Jolie B Boudreaux (OWNER) |
| Authorized Official Contact | 4054106378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revision Counseling 2902 Golden Harvest Ln Fort Collins CO 80528-3137 Ph: (405) 410-6378 | Revision Counseling 2625 Redwing Rd Fort Collins CO 80526-6313 Ph: (405) 410-6378 |
| NPI Number | 1891262200 |
|---|---|
| Provider Enumeration Date | 10/24/2018 |
| Last Update Date | 10/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891262200 | NPI | - | NPPES |
| 67175031 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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