Individual
CAIT OLDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LPC
Contact information
Practice address
2120 MILESTONE DR STE 103, FORT COLLINS, CO 80525-5761
(970) 829-8780
Mailing address
1625 DOGWOOD CT, FORT COLLINS, CO 80525-2022
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0019803
CO
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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