Individual
JEANINE TEN BROECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2760 N CAREFREE WAY, CRESTONE, CO 80229
(970) 844-5570
Mailing address
PO BOX 631, CRESTONE, CO 81131-0631
(970) 844-5570
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5924
CO
Other
Enumeration date
07/10/2008
Last updated
11/20/2024
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