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Organization
RESILIENCE REWIRED THERAPY AND NEUROFEEDBACK, LLC
Active
Organization
RESILIENCE REWIRED THERAPY AND NEUROFEEDBACK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADA HENDRICKSON (THERAPIST)
(719) 728-9239
Entity
Organization
Contact information
Practice address
4291 AUSTIN BLUFFS PKWY STE 108, COLORADO SPRINGS, CO 80918-2903
(719) 728-9239
Mailing address
1204 WAKITA DR, COLORADO SPRINGS, CO 80915-3013
(719) 728-9239
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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