Individual
MR. JONAH ISAAC BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
323 W DRAKE RD STE 216, FORT COLLINS, CO 80526-8120
(970) 290-0336
Mailing address
2424 COVENTRY CT, FORT COLLINS, CO 80526-1282
(970) 290-0336
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0011774
CO
Other
Enumeration date
01/27/2011
Last updated
07/21/2022
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