| Sarah Breseke | |
|
1136 E Stuart St Ste 101 Fort Collins CO 80525-1195 | |
| (573) 639-0112 | |
| Not Available |
| Full Name | Sarah Breseke |
|---|---|
| Speciality | Counselor |
| Location | 1136 E Stuart St Ste 101, Fort Collins, Colorado |
| Authorized Official Name and Position | Sarah Breseke (OWNER) |
| Authorized Official Contact | 5736390112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sarah Breseke 616 Sycamore St Fort Collins CO 80521-1938 Ph: (573) 639-0112 | Sarah Breseke 1136 E Stuart St Ste 101 Fort Collins CO 80525-1195 Ph: (573) 639-0112 |
| NPI Number | 1558852566 |
|---|---|
| Provider Enumeration Date | 05/24/2018 |
| Last Update Date | 05/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558852566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LPC.0004992 (Colorado) | Primary |
| 261Q00000X | Clinic/center | 0004992 (Colorado) | Secondary |
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