| Willow Therapy Pllc | |
|
509 Scott Ave Ste 2b Woodland Park CO 80863-1294 | |
| (719) 201-8714 | |
| Not Available |
| Full Name | Willow Therapy Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 509 Scott Ave Ste 2b, Woodland Park, Colorado |
| Authorized Official Name and Position | Candice Kaye Berger (OWNER) |
| Authorized Official Contact | 7192018714 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Therapy Pllc Po Box 116 Divide CO 80814-0116 Ph: () - | Willow Therapy Pllc 509 Scott Ave Ste 2b Woodland Park CO 80863-1294 Ph: (719) 201-8714 |
| NPI Number | 1043836687 |
|---|---|
| Provider Enumeration Date | 06/19/2020 |
| Last Update Date | 06/19/2020 |
| Certification Date | 06/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043836687 | NPI | - | NPPES |
| LPC.0014523 | Other | CO | DORA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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