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Individual

JACOB RICHARD KALLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 495-8020
(970) 495-7686
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-2421
(970) 490-4156

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.00020835
CO

Other

Enumeration date
03/17/2021
Last updated
10/18/2024
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