Organization
MAMA BIRD WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HANLIN LCSW (OWNER)
(303) 835-3552
Entity
Organization
Contact information
Practice address
424 E SIMPSON ST, LAFAYETTE, CO 80026-2328
(303) 835-3552
Mailing address
2013 E 167TH WAY, THORNTON, CO 80602-7650
(303) 835-3552
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSW.00002154
CO
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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