Individual
JEREMY RIDDELL-KAUFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, MA
Contact information
Practice address
2216 24TH AVE, LONGMONT, CO 80501-7542
(831) 601-8978
Mailing address
2216 24TH AVE, LONGMONT, CO 80501-7542
(831) 601-8978
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC.0019935
CO
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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