Organization
ABUNDANT LIFE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA WILSON (BILLING)
(307) 222-2013
Entity
Organization
Contact information
Practice address
1401 S TAFT AVE STE 206, LOVELAND, CO 80537-6962
(307) 274-4398
Mailing address
PO BOX 21511, CHEYENNE, WY 82003-7029
(307) 274-4398
(307) 369-4039
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/06/2018
Last updated
09/01/2020
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