Individual
JODI RAE MATHISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
443 CO 105, PALMER LAKE, CO 80133
(719) 602-0914
Mailing address
17360 CARIBOU DR E, MONUMENT, CO 80132-8552
(719) 761-4249
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0013952
CO
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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