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Organization
FORT COLLINS COMMUNITY CLINIC LLC
Active
Organization
FORT COLLINS COMMUNITY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA MAYA CHATTERJEE (MARRIAGE AND FAMILY THERAPIST)
(415) 728-2191
Entity
Organization
Contact information
Practice address
1507 RIVERSIDE AVE, FORT COLLINS, CO 80524-4382
(415) 728-2191
Mailing address
309 S LOOMIS AVE, FORT COLLINS, CO 80521-2542
(415) 728-2191
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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