Individual
JIM R KLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
760 WHALERS WAY, SUITE C-200, FORT COLLINS, CO 80525-3370
(970) 495-4853
(970) 204-7883
Mailing address
1907 TOPANGA CT, FT COLLINS, CO 80528-6278
(970) 495-4853
(970) 204-7883
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
989163
CO
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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