Individual
AUTUMN RAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4115 BOARDWALK DR, FORT COLLINS, CO 80525-5945
(970) 493-4580
Mailing address
3721 PRECISION DR, FORT COLLINS, CO 80528-4547
(720) 357-4174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCC.0019377
CO
Other
Enumeration date
05/02/2022
Last updated
05/02/2022
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