Individual
JORDAN ANTHONY YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, ATR
Contact information
Practice address
6654 GUNPARK DR STE 200F, BOULDER, CO 80301-3384
(303) 990-7380
Mailing address
5126 WILLIAMS FORK TRL APT 205, BOULDER, CO 80301-6607
(303) 990-7380
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0020902
CO
221700000X
Art Therapist
22-477
CO
Other
Enumeration date
10/19/2022
Last updated
07/02/2024
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